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Social determinants of health and adverse maternal and birth outcomes in adolescent pregnancies: A systematic review and meta‐analysis
Abstract
Background: Adverse outcomes in adolescent pregnancies have been attributed to both biological immaturity and social determinants of health (SDOH). The present systematic review evaluated the evidence on the association between SDOH and adverse maternal and birth outcomes in adolescent mothers. Methods: Comprehensive literature searches were conducted to identify observational studies evaluating the relationship between SDOH and adverse adolescent pregnancy outcomes. Study selection, risk of bias appraisal, and data extraction of study characteristics were independently performed by two reviewers. Pooled odds ratios (pOR) with 95% confidence intervals (95% CI) were calculated to assess the association between SDOH and adverse birth outcomes. Results: Thirty‐one studies met the inclusion criteria. The most frequently evaluated SDOH was race while the most commonly reported maternal and birth outcomes were caesarean section and preterm birth (PTB), respectively. The risk of bias of included studies was fair on the Newcastle‐Ottawa Scale. Meta‐analyses of retrospective cohort studies showed that, compared to White adolescent mothers, African American teens had increased odds of PTB (pOR 1.67; 95% CI 1.59, 1.75) and low birthweight (pOR 1.53; 95% CI 1.45, 1.62). Rural residence was consistently linked with PTB while low maternal socio‐economic (SES) and illiteracy were found to increase the risk of adolescent maternal mortality and LBW infants. Conclusion: Social determinants of health contribute to the risk of adverse pregnancy outcomes in adolescent mothers. African American race, rural residence, inadequate education, and low SES are markers for poor pregnancy outcomes in adolescent mothers. Further research needs to be done to understand the underlying causal pathways to inequalities in adolescent pregnancy outcomes.
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“While there have been a number of systematic reviews that examine the impact of deprivation,6 12 13 these are out of date and focus on area-based measures (such as the Index of Multiple Deprivation) as an inadequate proxy for individual measures of socioeconomic status (SES), which can be more difficult to collate.”
From Socioeconomic inequalities and adverse pregnancy outcomes in the UK and Republic of Ireland: a systematic review and meta-analysis (2021) · cites this paper as [13]
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“with a recent systematic review and meta-analysis showing significant associations between the wider social determinants of health and negative outcomes, including preterm birth [58]”
From Mediators of socioeconomic inequalities in preterm birth: a systematic review (2022) · cites this paper as [58]
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Cited by
Disparities in Health Care and the Digital Divide
Saeed, S. A., & Masters, R. M. (2021) · Current Psychiatry Reports · doi:10.1007/s11920-021-01274-4 · Cited by 578
Thomson, K., Moffat, M., Arisa, O., Jesurasa, A., Richmond, C., Odeniyi, A., Bambra, C., Rankin, J., Brown, H., Bishop, J., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-042753 · Cited by 154
Mediators of socioeconomic inequalities in preterm birth: a systematic review
McHale, P., Maudsley, G., Pennington, A., Schlüter, D. K., Barr, B., Paranjothy, S., & Taylor-Robinson, D. (2022) · BMC Public Health · doi:10.1186/s12889-022-13438-9 · Cited by 89
Zhang, T., Wang, H., Wang, X., Yang, Y., Zhang, Y., Tang, Z., & Wang, L. (2020) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-020-03022-7 · Cited by 66
Midwifery continuity of care for women with complex pregnancies in Australia: an integrative review
Fox, D., Scarf, V., Turkmani, S., Rossiter, C., Coddington, R., Sheehy, A., Catling, C., Cummins, A., & Baird, K. (2023) · Women and Birth · doi:10.1016/j.wombi.2022.07.001 · Cited by 39
Metadata
- Authors
- Amjad, S., MacDonald, I., Chambers, T., Osornio‐Vargas, A., Chandra, S., Voaklander, D., & Ospina, M. B.
- Venue
- Paediatric and Perinatal Epidemiology
- Publisher
- Wiley
- Published
- 2018-12-05
- Volume
- 33
- Issue
- 1
- Pages
- 88-99
- ISSN
- 0269-5022
- 1365-3016
- Cited by
- 212
- References
- 1
- Language
- en
- Funders
- Women and Children's Health Research Institute
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- Amjad, S., MacDonald, I., Chambers, T., Osornio‐Vargas, A., Chandra, S., Voaklander, D., & Ospina, M. B. (2019). Social determinants of health and adverse maternal and birth outcomes in adolescent pregnancies: A systematic review and meta‐analysis. Paediatric and Perinatal Epidemiology. https://doi.org/10.1111/ppe.12529
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