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.

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.

There has been a dramatic increase in very young adolescent pregnancies in recent years, with pregnancies documented in children as young as 10 years old, likely from sexual abuse. This article presents a 10-year-old female who initially consulted at the emergency room in her 27th week of pregnancy as a result of recurrent sexual abuse. Prompt assessment, diagnosis, and appropriate referrals to Obstetrics, Pediatric Adolescent Clinic, Psychiatry, and Child Protection Unit rendered optimal management for the patient. Dilemmas encountered in managing the case included preterm labor, large-for-gestational-age baby, immature pelvis, and approach to the appropriate mode of delivery compounded with management of trauma from sexual abuse. A multidisciplinary approach in managing these dilemmas achieved optimal outcomes with the patient delivering a live baby boy, appropriate for gestational age via cesarean section at term.
Child abuse ; pregnancy in adolescence ; preteen pregnancy ; teenage pregnancy ; sexual

Background. Peripartum cardiomyopathy (PPCM) is a rare form but life-threatening disease condition of the myocardium resulting in decreased ventricular contractility that occurs in a previously healthy woman during the peripartum period. Currently, in our country and probably worldwide there is an absence of epidemiologic data and description of the profile and outcome of PPCM patients less than 19 years old.

Objective. To determine the clinical profile and outcome of peripartum cardiomyopathy among teenagers (14-18 years old) at the University of the Philippines-Philippine General Hospital from 2004-2013

Methods. All patients aged 14-18 years old referred to Section of Pediatric Cardiology during a 10-year period from 2004-2013 who were diagnosed to have peripartum cardiomyopathy fulfilled the criteria set by National Heart, Lung and Blood Institute (NHLBI) were included in the study. We retrieved the medical records of the 25 patients diagnosed with peripartum cardiomyopathy from 2004-2013. The 2D echocardiogram was retrieved from the Pediatric Cardiology Section.

Results. There were 25 teenagers with a mean age of 17 years old diagnosed with PPCM in UP-PGH in 2004-2013. Twenty-one patients (84%) had one sexual partner and two (8%) patients had multiple sexual partners. Their common co-morbidity was preeclampsia. The most common symptoms were dyspnea, easy fatigability, and orthopnea. Most patients presented with NYHA functional class III-IV.

The majority had poor LV contractility (mean EF of 29% and a mean FS of 12.7 %). All had left ventricular enlargement with mean LVEDd of 5.3 cm and mean LVESd of 4.2 cm. LV function improved in 72% of patients after six months. Four (16%) patients died because of myocardial failure.

Conclusion. Peripartum cardiomyopathy is a rare form of cardiomyopathy but it can occur among teenagers age 14-18 years of age. Compared with the previous study our patients are younger, and with a low prevalence of multiple pregnancy and promiscuity. Similar to other studies, preeclampsia and premature labor necessitating the use of tocolytics with Terbutaline are common comorbidities.

Background: According to the WHO, about 16 million girls at the age of 15–19 years give birth each year. In the Philippines, 600 live births a day are registered under teenage mothers. At Mariano Marcos Memorial Hospital and Medical Center, 12% of all obstetric admissions yearly are teenagers. The American College of Obstetricians and Gynecologists recommends long‑acting reversible contraception (LARCs), in the form of intrauterine device and progestin subdermal implant as pregnancy prevention options for young mothers. The objective of the study was to identify the prevalence and determinants of long‑acting reversible contraception (LARC) initiation among teenage mothers in Mariano Marcos Memorial Hospital and Medical Center. Methodology: Prospective observational study: A self‑administered questionnaire was given to the respondents wherein they ranked determinants involved in their selection of a contraceptive method on a scale of 1–4 (1 being the most important, and 4, the least important. Results A total of 162 teenage mothers participated in the study. Majority of the respondents were 17–18 years old, enrolled up to high school, single, unemployed, and primiparas. Eighty‑seven percentage of all teenage mothers admitted at Mariano Marcos Memorial Hospital and Medical Center from December 2020 to December 2021 used long‑active reversible contraception. Ranked from most (1) to least (4) important, the respondents considered: (1) Effectivity, (2) Long duration, (3) Family influence, and (4) Peer influence as their determinants for initiating LARC method. The high effectiveness and long duration of LARC were the primary reasons for initiation, while the least factors they considered were that of peer and family influence.
Intrauterine Devices ; Pregnancy in Adolescence

Background: The 2013 National Demographic and Health Survey (NDHS) showed that 1 in 10 young Filipino women aged 15–19 years are childbearing. Yet, teenage pregnancy is known to be associated with complications in the mother and the child. Objective: This study aimed to describe the sociodemographic characteristics and obstetric and perinatal outcomes of teenage pregnancy among Filipino women aged 13–19 years at the Philippine General Hospital. Methods: This is a retrospective study consisting of reviewing the hospital records of teenage mothers from years 2014–2016. Descriptive statistics were used to analyze the gathered data. Results: Almost 50% of the cases of adolescent pregnancy yielded obstetric and perinatal complications. The odds of having abnormal obstetric outcome among mothers with obstetric score of g1 is 7.8 times (95% CI: 2.0 to 30.7) higher as compared to other gravida scores and the odds of having at least one perinatal disorder decreases by 19% (95% CI: 6% to 30%) as the mothers regularly visit an obstetric clinic. This study also showed that among the pregnant adolescents, most of their partners were of legal age. Thirty-nine (23.9%) of them were seen by the Adolescent Service while 31(19%) were seen by the Child Protection Unit (CPU). Conclusion With the noted obstetric and perinatal outcomes, teenage pregnancy is an important issue that needs to be dealt with. To ensure good outcomes, provision of health care services designed particularly to cater to the needs of adolescent mothers should be properly and timely implemented. A referral to the Adolescent Service and CPU will greatly improve policies pertaining to provision of holistic care and protection services to teenage mothers.
Pregnancy in Adolescence