BACKGROUND

Maternal malnutrition is a major cause of low birth weight (LBW) newborn outcome especially among adolescent mothers. It is one of the key drivers of child stunting and initiates the vicious cycle of intergenerational malnutrition. The body mass index prior to pregnancy or at the initial trimester is currently being used to establish the desired weight gain throughout pregnancy. However, Filipino adolescents often delay their first antenatal visit at a later stage of pregnancy. Without a baseline weight, the establishment of appropriate weight gain and nutritional status is often challenging. Mid-upper arm circumference (MUAC) was proven to be a good proxy measure of acute malnutrition, however, there was no global consensus on what MUAC cut-off point to use to identify pregnant adolescents at risk for delivering LBW babies. Finding the optimal cut-off could facilitate early identification and intervention of pregnant adolescents who are nutritionally at risk and could eventually break the cycle of intergenerational malnutrition.

The study aims to determine the association of maternal MUAC and the birth weight outcomes among newborn deliveries of adolescents in a tertiary hospital for a period of six months and to identify the optimal maternal MUAC cut-off point that can be used to predict low birth weight outcome among newborn deliveries of adolescents in a tertiary hospital.

A cross-sectional study was conducted among adolescents ages 10 to 19 years who delivered babies in a tertiary hospital in the Philippines for a period of six months. Maternal MUAC and LBW outcome were documented, and their association was determined using a logistic regression analysis. To measure diagnostic accuracy, the sensitivity, specificity, and the area under the curve were taken for each MUAC point. A receiver operating characteristic (ROC) curve was used to aid the MUAC cut-off determination.

Out of 237 newborn deliveries, 35% were noted with low birth weight while 65% had normal birth weight. Most of the mothers were in their late adolescence at 78%. The crude association for the MUAC cut-offs ≤23.00 cm, ≤23.50 cm, and ≤24.00 cm and LBW showed a significant value of 2.19, 2.25, and 2.39 at 95% CI, respectively. However, it is only the cut-off ≤24.00 cm that showed significant results for adjusted association by the logistic regression analysis. The MUAC cut-off ≤24.00 cm also showed a better trade-off value between the sensitivity and specificity. Furthermore, the optimal maternal MUAC measurement that predicts LBW newborn outcome points to ≤24.00 cm cut-off based on the ROC curve.

This study shows that the maternal MUAC is predictive of LBW outcome among adolescent deliveries.A MUAC cut-off of ≤24.00 cm was superior to lower cut-offs studied. The pregnant adolescents might need a higher MUAC cut-off than adults to allow timely intervention and prevention of poor neonatal outcomes. By doing this simple screening test, suspected pregnant adolescents can be easily identified and referred for further confirmatory testing.

INTRODUCTION

Adolescent pregnancy is enduringly perceived as posing a considerable social threat in the Philippines. Recent data from the Commission on Population and Development shows that over 40,000 births annually are from adolescent mothers aged 10 to 14 years, with many of these early pregnancies potentially linked to rape, forced sex, and abuse. Most studies in the past focus on causes and prevention. Limited research explores the lived experiences of early adolescent mothers, especially in the context of unwanted pregnancies.

This study was conducted to determine the lived experiences of unwanted pregnancy among early adolescents age 12 to 15 years old in Zamboanga City.

The study employed an Interpretative Phenomenological Study Design which involved understanding how the adolescents make sense of events, emotions, and interactions in their experiences. Ten (10) adolescent girls with experience of unwanted pregnancy were interviewed.

Analysis of transcripts generated three superordinate themes: (1) Living in the challenges of the present, (2) Facing the future with resilience, (3) Escaping the past. After identifying similarities across cases, two cross-case themes were generated: (1) Dysfunctional family background as a contributor to early pregnancy, and (2) The importance of relying on significant others for support.

The study revealed that unwanted pregnancies were influenced by dysfunctional family environments, socioeconomic challenges, and, in some cases, sexual exploitation. The participants faced emotional distress, financial instability, and social stigma, with support from family playing a critical role in the coping process. Despite the initial adversity, participants demonstrated resilience, finding ways to endure, adapt, and thrive.

INTRODUCTION

One significant challenge facing the Filipino youth today is adolescent pregnancy, as the nation having one of the highest rates of adolescent births rates in the ASEAN region. Various sociocultural, economic, and individual factors have been identified as contributing factors. However, the impact of family, including maternal intergenerational factors, has yet to be substantially explored. This study aimed to investigate the root cause of adolescent pregnancy in San Juan city through the identification and examination of common familial factors.

This was an unmatched case-control study with a 1:2 ratio using a non-probability sampling. It included two groups of adolescent females: pregnant/ever pregnant and non-pregnant) aged 13 to 19. A three-part modified questionnaire was used to collect the data and was administered through a faceto-face interview.

This study revealed that adolescent women in grandparent-headed families are 4.47 (CI: 1.33, 15.0) times more likely to be pregnant as adolescents compared to the reference group. Adolescents with low educational attainment among their fathers and mothers are 4.25 (CI: 1.80, 10.10) and 3.30 (CI: 1.58, 6.93) times more likely to get pregnant, respectively. Additionally, if a mother is unemployed, they were 1.89 (CI: 1.09, 3.30) times more likely to get pregnant, and if their mother passed away, they were 4.24 (CI: 1.03, 17.42) times more likely to experience pregnancy. Moreover, they are 7.69 (CI: 4.21, 14.02) and 9.07 (CI: 2.74, 30.03) times more likely to get pregnant if their mother and sister have a history of adolescent pregnancy. There was also a significant association found between severe family dysfunctionality (p=0.0430) and adolescent pregnancy. Cases were 8.33 times less likely to have a severely dysfunctional family than controls.

A statistically significant association was found between adolescent pregnancy and several familial factors, including exposure to a grandparent-headed family structure, low parental educational attainment, maternal unemployment, maternal death, and a family history of early pregnancy involving the mother or an older sister. While moderate family dysfunction was also associated, this relationship was not statistically significant.

Objective To analyze the distribution of platelet antibodies in hospitalized patients and explore the clinical significance of platelet antibody detection. Methods A total of 95 987 hospitalized patient cases from a tertiary hospital in Xi'an from April 1, 2021 to December 31, 2023 were collected. Platelet antibodies were detected by solid-phase agglutination method. Statistical analysis was performed on variables including gender, age, blood type, department, history of blood transfusion, pregnancy history, and disease type. Results Among 95 987 hospitalized patients, the positive rate of platelet antibody detection reached 4.35%. The positive rate of platelet antibodies in female hospitalized patients (5.29%) was higher than that in male patients (3.31%), and the difference was statistically significant (x²=224.124). The positive rate of platelet antibodies in those with pregnancy history (7.92%) was higher than that in those without pregnancy history (4.19%), and the difference was significant (x²=292.773). Similarly, the positive rate of platelet antibodies in those with transfusion history (7.79%) was higher than that in those without transfusion history (3.97%), and the difference was significant (x²=300.209). There was a significant correlation between the positive rate of platelet antibodies and the number of pregnancies (x²=91.061). Conclusion The positive rate of platelet antibodies in 95 987 inpatient cases was 4.35%. The positive rate of platelet antibodies had a close relationship with a history of blood transfusions and pregnancies, and it increased with the number of pregnancies. For patients with multiple transfusion histories and pregnancy histories, screening for platelet antibodies holds significant diagnostic value.
Humans ; Female ; Male ; Adult ; Middle Aged ; Blood Platelets/immunology* ; Inpatients ; Aged ; Pregnancy ; Young Adult ; Adolescent ; Aged, 80 and over ; Autoantibodies/blood*

Background: Maternal malnutrition is a major cause of low birth weight (LBW) newborn outcome especially among adolescent mothers. It is one of the key drivers of child stunting and initiates the vicious cycle of intergenerational malnutrition. The body mass index prior to pregnancy or at the initial trimester is currently being used to establish the desired weight gain throughout pregnancy. However, Filipino adolescents often delay their first antenatal visit at a later stage of pregnancy. Without a baseline weight, the establishment of appropriate weight gain and nutritional status is often challenging. Mid-upper arm circumference (MUAC) was proven to be a good proxy measure of acute malnutrition, however, there was no global consensus on what MUAC cut-off point to use to identify pregnant adolescents at risk for delivering LBW babies. Finding the optimal cut-off could facilitate early identification and intervention of pregnant adolescents who are nutritionally at risk and could eventually break the cycle of intergenerational malnutrition. Objectives: The study aims to determine the association of maternal MUAC and the birth weight outcomes among newborn deliveries of adolescents in a tertiary hospital for a period of six months and to identify the optimal maternal MUAC cut-off point that can be used to predict low birth weight outcome among newborn deliveries of adolescents in a tertiary hospital. Methods. A cross-sectional study was conducted among adolescents ages 10 to 19 years who delivered babies in a tertiary hospital in the Philippines for a period of six months. Maternal MUAC and LBW outcome were documented, and their association was determined using a logistic regression analysis. To measure diagnostic accuracy, the sensitivity, specificity, and the area under the curve were taken for each MUAC point. A receiver operating characteristic (ROC) curve was used to aid the MUAC cut-off determination. Results: Out of 237 newborn deliveries, 35% were noted with low birth weight while 65% had normal birth weight. Most of the mothers were in their late adolescence at 78%. The crude association for the MUAC cut-offs ≤23.00 cm, ≤23.50 cm, and ≤24.00 cm and LBW showed a significant value of 2.19, 2.25, and 2.39 at 95% CI, respectively. However, it is only the cut-off ≤24.00 cm that showed significant results for adjusted association by the logistic regression analysis. The MUAC cut-off ≤24.00 cm also showed a better trade-off value between the sensitivity and specificity. Furthermore, the optimal maternal MUAC measurement that predicts LBW newborn outcome points to ≤24.00 cm cut-off based on the ROC curve. Conclusion This study shows that the maternal MUAC is predictive of LBW outcome among adolescent deliveries.A MUAC cut-off of ≤24.00 cm was superior to lower cut-offs studied. The pregnant adolescents might need a higher MUAC cut-off than adults to allow timely intervention and prevention of poor neonatal outcomes. By doing this simple screening test, suspected pregnant adolescents can be easily identified and referred for further confirmatory testing.
Pregnancy in Adolescence

OBJECTIVES

This study aimed to determine the maternal and fetal effects of hyperglycemia, and to compare the clinical outcomes between pregnant teenagers and adult women with gestational diabetes mellitus (GDM).

This was a retrospective cohort study among pregnant women who tested positive for GDM by 75-gram oral glucose tolerance test (OGTT). Data was collected from the 1st of January 2015 to the 31st of December 2019. Maternal and fetal outcomes and the factors associated with maternal and neonatal outcomes among teenage women and adult women with GDM were studied.

A total of 254 charts of women with GDM were reviewed. Overall, adverse maternal outcomes were found in 94.12% and 90% of teenage and adults, respectively; and were almost more likely among primigravida (OR=3.984, CI=1.32-12, p=0.014). The study also showed less probability of having adverse maternal outcomes among multipara and grand multipara women (OR=0.2545, CI=0.08-0.79, P=0.018 and OR=0.1091, CI=0.03-0.45, p=0.002) respectively. Adverse neonatal outcomes were more likely among women who had prior delivery of macrosomic baby (OR=21.9091, CI=1.28-3.73, P=0.033). No adverse fetal outcome records were seen among teenage mothers, while adult women had 5.45% incidence.

Adverse maternal and neonatal outcomes were not significantly higher in the teenage GDM population compared to adult GDM. However, diagnosing and managing GDM among these groups would be beneficial considering their life expectancy and the need for a lifelong preventive program to avoid future development of Type 2 DM (T2DM) and its complications.

BACKGROUND

While adolescent pregnancies in the Eastern Visayas region of the Philippines have declined over the past five years, young mothers remain at risk of repeat pregnancies, which continue to expose them and their children to health and socioeconomic risks in this vulnerable region.

This study aims to collect baseline information on mothers who experienced early pregnancy in Eastern Visayas and to identify significant differences in maternal characteristics based on type of residence and age. The findings will be used by a nongovernmental organization to plan and develop targeted interventions for this vulnerable population.

This study utilized a descriptive cross-sectional design to collect data on mothers who experienced early pregnancy in four selected provinces of Eastern Visayas. Data were analyzed using descriptive statistics, chi-square tests, an independent t-test, and the Mann-Whitney U test.

A total of 296 mothers participated in the survey. Among them, 80.1% were in high school during their first pregnancy, and 88.2% were unemployed at the time of the study. The youngest age at first pregnancy was 12 years. The participants' male partners were at least five years older (39.8%) and ten years older (11.1%). Significant differences were observed in the use of family planning method, number and status of pregnancies, and history of preterm labor.

Results suggest that adolescent pregnancy remains a public health concern in Eastern Visayas, particularly among lowincome teenagers with limited educational attainment, whose parents also had minimal education. The youngest reported age of pregnancy was 12 years. Therefore, efforts should focus on increasing access to family planning services, providing comprehensive reproductive health education, and enhancing maternal and child health services.

The behavioral problems of children and adolescents are becoming more and more serious, and the prevalence rate is increasing year by year. The overall trend is increasing, which has become one of the important public health issues of global concern. There are many influencing factors for behavioral problems in children and adolescents, including genetic, psychosocial, family and early life environment. Among them, maternal screen exposure during pregnancy is a contributing factor that deserves attention and has practical intervention significance. This study systematically evaluated the association between maternal mobile phone screen time during pregnancy and children's internalizing and externalizing behavioral problems, its potential biological mechanisms and relevant intervention measures, in order to create a good intrauterine environment for fetal neurodevelopment and further reduce the occurrence of children's behavioral problems.
Adolescent ; Child ; Female ; Pregnancy ; Humans ; Problem Behavior ; Screen Time ; Cell Phone ; Family ; Maternal Exposure

OBJECTIVE: To investigate whether anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes were correlated with unexplained recurrent miscarriages. METHODS: In our a single-center retrospective study, 283 patients with at least one unexplained miscarriage who visited the Third Hospital of Peking University between January 2021 and August 2023, aged between 18-40 years, and tested for anti-phosphatidylserine/prothrombin antibodies IgG or IgM subtypes, were included. The patients with either positive IgG or IgM anti-phosphatidylserine/prothrombin antibody were regarded as positive for anti-phosphatidylserine/prothrombin antibody. SPSS 26.0 software was used for statistical analysis. Chi-square test and Logistic regression analysis were used to study the correlation of anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes with unexplained recurrent miscarriages. And the diagnostic sensitivity, specificity, the positive predictive value, the negative predictive value of anti-phosphatidylserine/prothrombin antibodies and its IgG or IgM subtypes in unexplained miscarriages was calculated with four-fold table. RESULTS: Chi-square analysis showed that anti-phosphatidylserine/prothrombin antibodies and its IgM subtypes were correlated with recurrent miscarriages (both P < 0.05), while the IgG subtype was not correlated with recurrent miscarriages (P>0.05). After adjusting with anticardiolipin antibodies, anti-β₂ glycoprotein antibodies, lupus anticoagulants, antinuclear antibodies, and age by Logistic regression analysis, anti-phosphatidylserine/prothrombin antibodies were correlated with unexplained recurrent miscarriages (OR=2.084, 95%CI 1.045-4.155, P < 0.05), and anti-phosphatidylserine/prothrombin antibody IgM subtypes were correlated with unexplained recurrent miscarriages (OR=2.368, 95%CI 1.187-4.722, P < 0.05).The sensitivity of anti-phosphatidylserine/prothrombin antibody in recurrent miscarriage was 65.43%, the specificity was 48.51%, the positive predictive value was 33.76%, and the negative predictive value was 77.78%. In the patients with recurrent miscarriages with negative classical antiphospholipid antibodies, the sensitivity of anti-phosphatidylserine/prothrombin antibody was 59.09%, the specificity was 63.23%, the positive predictive value was 40.63%, and the negative predictive value was 78.40%. The sensitivity of the anti-phosphatidylserine/prothrombin antibody IgM subtype for the diagnosis of recurrent miscarriage was 65.43%, the specificity was 50.99%, the positive predictive value was 34.87%, and the negative predictive value was 78.63%. CONCLUSION Anti-phosphatidylserine/prothrombin antibody and IgM subtype antibody are correlated with unexplained recurrent miscarriages in patients with at least one unexplained miscarriage. Whether positive anti-phosphatidylserine/prothrombin antibody or IgM subtype could predict future unexplained recurrent miscarriages warrants a prospective study.
Pregnancy ; Female ; Humans ; Adolescent ; Young Adult ; Adult ; Prothrombin ; Retrospective Studies ; Phosphatidylserines ; Prospective Studies ; beta 2-Glycoprotein I ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome/diagnosis* ; Antibodies, Anticardiolipin ; Abortion, Habitual ; Immunoglobulin G ; Immunoglobulin M

Objective: To compare the survival outcomes between surveillance and adjuvant chemotherapy in patients with stage Ⅰ ovarian immature teratoma (IMT) underwent fertility-sparing surgery. Methods: Clinical and pathological records of patients with stage Ⅰ ovarian IMT between Jan. 2011 to Feb. 2023 were collected from Peking Union Medical College Hospital, except stage Ⅰa grade 1. The consultation of risks and benefits regarding adjuvant chemotherapy was conducted by gynecologic oncologists. A shared decision about surveillance or chemotherapy was made by physician and patients or their guardians. Patients who finally decided to undergo surveillance were included in the surveillance group (n=40), the others were included in the adjuvant chemotherapy group (n=63). Clinical characteristics, treatment and survival outcomes were analyzed and compared between two groups. Results: A total of 103 patients were included. The median age of initial diagnosis was 20 years old (range: 3-39 years old), and the median follow-up time was 31 months (range: 1-254 months). The age, International Federation of Gynecology and Obstetrics (FIGO) stage, pathological grade, surgical method, and preoperative and postoperative alpha-fetoprotein levels in the surveillance group and the adjuvant chemotherapy group were similar (all P>0.05). The surgical approach and maximum tumor diameter between two groups were significantly different (all P<0.05). Forty patients of the surveillance group were identified, only one patient with stage Ⅰa grade 2 IMT who underwent cystectomy had malignant recurrence on the same ovary. Another 63 patients received adjuvant chemotherapy after surgery, five patients had malignant recurrence, and two of them died of disease progression after relapsed. There were no significant differences in disease-free survival (DFS;20 vs 36 months) and overall survival (OS; 23 vs 39 months) between the surveillance group and the adjuvant chemotherapy group (follow-up time censored at 72 months; DFS: P=0.325, OS: P=0.278). Conclusions: There are no differences in survival outcomes between patients with stage Ⅰ ovarian IMT underwent adjuvant chemotherapy or not. Active surveillance might be safe and preferable in stage Ⅰ IMT patients underwent complete resection of tumor.
Pregnancy ; Humans ; Female ; Child, Preschool ; Child ; Adolescent ; Young Adult ; Adult ; Prognosis ; Watchful Waiting ; Neoplasm Staging ; Ovarian Neoplasms/surgery* ; Chemotherapy, Adjuvant ; Teratoma/surgery* ; Retrospective Studies