In many communities adolescent pregnancies especially the unmarried teen pregnancies carries a social stigma because most of their pregnancies are unwanted and unplanned. It is happening in every socioeconomic group. In developing countries early pregnancies are commonly associated with poverty and lower educational levels.

The teen mothers have more obstetric complications due to their underdeveloped pelvis. Adverse childhood environment, bad parenting and lack of proper education are the leading causes behind the teen pregnancy. Media also have a major influence on early pregnancy. Adolescent mother are more likely to drop out high school and due to lack of job skills unemployment is a common problem among them. Most of the babies of the adolescent mother are premature and low birth weight which is associated with the lifelong complications of the babies. By getting early and regular antenatal check up, taking healthy diet and living healthy life and also by raising public awareness and social mobilization the incidence of early pregnancy and their obstetric complications can be reduced.

Keywords: adolescent pregnancy, maternal morbidity, school dropout, unemployment

In previous centuries adolescent pregnancy was normal but in developed countries in 20^th century teenage mothers are common.¹ According to the definition of WHO Adolescent pregnancy can be defined as pregnancy in between the age of 15 to 19years of age.² Early marriage, lack of knowledge of contraceptive methods , drug abuse, adverse childhood environment are the leading causes of early pregnancy. Adolescent pregnancy are higher risk for some obstetric complications such as placenta praevia, Pregnancy induced hypertension, preterm labour, severe anaemia and preeclampsia.³ The babies of adolescent mothers are at higher risk of psychosocial problem such as intellectual and socio-emotional delays.⁴ The social consequences of unmarried teen mother are severe.²Teenage mothers are at higher risk of suffering from sexually transmitted diseases and HIV infection due to lack of proper knowledge and immaturity. Through educated and trained community health worker by using a strength-based approach we can develop a sustain partnerships with the families at the community level.

Importance of parent child bondage

1. A secured parent-child interaction provide the foundation for child’s learning.⁵
2. Poverty has the leading role in parent-child relationships which directly influence on child’s behavioral outcome. In poor family children are living with a lot of stress and instable life.⁶
3. With the responsive care of the parent’s young children develop the skills that are required to succeed in life and has the adaptive capacity in the different environment.⁷

The importance of parenting is reflected in all stages of life: building positive parent-child relationships from the beginning

1. Early parent-child bonding has a powerful effect on the children’s problem-solving capacities.⁸
2. Positive parent-child relationships teach their children how to make healthy relationships with the adults and the peers.⁹
3. Family has a greater role in developing lifelong motivation of their children.¹⁰
4. Warm and responsive parenting has a greater role for the healthy brain development of their child.¹¹
5. For the Infant’s survival and development positive parenting has a leading role.¹²
6. During toddlerhood positive parent-child interactions help to develop the sense of autonomy of their child.¹³
7. Adolescents who have been reared carefully show more success in school and have fewer behavior problems.¹⁴

Factors related to the adolescent pregnancy

There are several causes that have influence on adolescent pregnancy. In many countries teenage girls are under pressure to marry and to be pregnant because of their poverty.² The possible causes of the adolescent pregnancy include:^2,15

Younger age

The teenagers often have unplanned sexual intercourse that can lead them to become pregnant.¹⁶

Poor school performance

Lack of positive parenting have a greater influence in their children’s poor school performance. Education itself has a major role to prevent early pregnancy.¹⁷

Economic instability

Poverty and teen pregnancy are most often interrelated.¹⁸

Early marriage

Early marriage is always related with early pregnancy.

Single or teen parents

Lack of knowledge of family planning methods. Improper knowledge about sex and family planning can lead adolescent at risk of pregnancy and obstetric complications.²

Role of drug and alcohol^18,19

Drug abuse and addiction have direct influence on unlawful sexual activity and social crime.

Violence against girls

In many industrialized countries sexual abuse can teenage girls at risk of early pregnancy.^20,21

Influence of media

Media has direct influence on early marriage, pregnancy and also unlawful act.²²

Possible complications

Maternal complications: Adolescent pregnancy is related with both in maternal and fatal morbidity and mortality due to increased risk of a lot of obstetric complications.²³ The other common complications include:

1. Reduce carrier opportunities as a consequence of early pregnancy and high school dropout rate.²⁴
2. Increase suicidal tendency.^2,24

Complications in child: Teen parents are in lack of intellectual maturity that is often related with uneventful Antenatal care and adverse fatal outcome.⁴ The babies of teen mothers are often premature and low birth weight. Majority of this baby are suffering from many lifelong complications like impaired psychosocial development.²⁶

Stillborn and neonatal death is more common related to teen mothers in many developed countries.² Children of teen mother are most often suffering from developmental disabilities and behavioural issues.^27,28 Some children of the adolescent mother due to their poor school performances fail to graduate and ultimately they are involving in some social criminal act and for this reason many middle and low income countries child labour is more common.²⁴

Health related complications: Poor dietary habits are common features among the teen girls which is the leading cause of their nutritional deficiency. Adolescent mother and their children are also at a higher risk of getting HIV infection due to their lack of knowledge.² Teen mother has underdeveloped pelvis. For this reason obstructed labour is very common that can lead to Eclampsia, fistula andultimately death ofboth the mother and the fetus.²

Preventive measures for the adolescent pregnancy

According to WHO guidelines the following preventive measures can be taken:²⁹

1. By making laws and policies against early marriage; prohibit pregnancy before the age of 20years and by strictly following those laws early pregnancy can be prevented.
2. By informing knowledge about the complication of the unsafe abortion among the teen girls.
3. By involving the political and community leaders for the formulating and enforcing laws and policies against early marriage.
4. By providing availability of the safe abortion care and comprehensive emergency obstetric care among the teen mother.
5. By creating awareness of the community people about delayed marriage.
6. By giving proper knowledge and education to the parent’s foe the retention of teen girls at the primary and secondary school level.
7. By ensuring punishment to those persons who are involved in coerced sexual act.
8. By providing social support to the adolescent girls specially who are at risk.
9. Role of health care personnel for the prevention of adolescent pregnancy:
10. For the health care providers Centres for Disease Control and Prevention has given the following suggestion.¹⁶
11. To make their clinic friendly for the teen by providing private and confidential services.
12. To be more knowledgeable about the adolescent reproductive health.
13. To be friendly to the teen mothers by providing them sex education and effective and safe contraceptive methods.

Every year a lot of children are born to teenage mother all over the world.² Adolescent pregnancy increasing the incidence of maternal mortality rate as well as the infant death. Public awareness is the main preventive measure for the early pregnancy. By involvement of both the Public and private sectors, by social mobilization, by providing evidenced base interventions involving the social workers, by easily availability and accessibility of the health care services in the community this social stigma can be preventable.^16,29 The teen girls need to be counselled properly. They should be friendly to their parents and must go to the health care providers when required and finally to be strong to overcome this critical situations.^25,29 Enhancing community awareness and proper implementation of the law against early marriage can reduce the rate of Adolescent pregnancy and its worst outcome.

We received cooperation from the local government authorities of Bangladesh, NIPSOM, Mohakhali, Dhaka, Bangladesh. We gratefully acknowledge the contribution of the research team who worked very hard to collect quality data in a timely manner.

Author declares that there is no conflict of interest.

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