Adolescence pregnancy in Montes Claros: occurence and implications

A presente investigacao tem como proposito dimensionar a ocorrencia da parturicao de adolescentes na rede hospitalar de Montes Claros, considerando as sinalizacoes de aumento de sua ocorrencia e as implicacoes associadas a gravidez neste segmento populacional. Partindo das Declaracoes de Nascidos Vivos (DNs), no periodo de' l 1997 a 2001, foram calculadas as proporcoes de adolescentes de 10 a 14 anos' de idade e de 15 a 19 anos em relacao ao total de partos, bem como a taxa especifica de fecundidade entre adolescentes residentes no municipio. Considerando o total de DNs preenchidas a cada ano, procedeu-se a caracterizacao das parturientes segundo idade) materna, frequencia adequada ao pre-natal superior a seis consultas e a via de parto, distinguindo o parto vaginal e cesarea. Dentre as variaveis desfecho, foi considerada a prematuridade, ou seja, as gestacoes abaixo de 37 semanas e as de 37 a 41 semanas (a termo), o baixo peso ao nascer tendo como criterio valores inferiores a 2.500 gramas, bem como, o apgar do 5º minuto abaixo de sete. A fim de identificar a intensidade das associacoes entre idade e cada uma das variaveis consideradas no estudo, foi calculada a estatistica CRAMER. Para efeito da relacao entre idade e desfechos da gravidez, levando em conta a frequencia ao pre-natal e a via de parto, foi calculada as razoes de probabilidade e a odds ratio, considerando como grupo de referencia, as proporcoes observadas entre as adultas (20 anos e mais), com frequencia adequada ao pre-natal e as que se submeteram ao parto vaginal. A proporcao de partos de adolescentes, da ordem de 21 por cento, apresentou poucas variacoes no periodo, acompanhando os valores do pais. A taxa especifica de fecundidade na adolescencia, por sua vez, variando de 3,01 a 2,02 por cem mulheres, diferentemente dos valores correspondentes observados no pais, apresentou taxas inferiores e tendencias decrescentea(au)The present investigation aims to measure the occurrence of adolescents’ parturition in the hospitals in Montes Claros. It considers the increase in the occurrence and the implications as asssociated to pregnancy in the population segment. Coming from the Declaração de Nascidos Vivos (DNs) / Alive Borns Declaration/ from 1997 to 2001, the proportion of adolescents from 10 to 14 years old anfrom 15 to 19 years old in relation to the total of births, as well as the specific tax of fecundity among the adolescents in this city. Considering the total of DNs filled out every year, it proceeded to the characterization of the parturients according to the motherhood age, the suitable frequency to prenatal, superior to six appointments and the birth via, distinguishing vaginal birth to cesarean birth. Among the ending variants, it was considered the prematurity, or better, the gestation period no longer than 37 weeks and the ones from 37 weeks to 41 (to the end), the low weight of the baby when it borns, taking as criteria the values lower than 2500gr, as well as, the apgar at the 5th minute beneath the seven. Cramer’s statistics was calculated to identify the intensity of the association between the age and each one of the variants. To the relation effect between age and the pregnancy end, considering the frequency to the prenatal appointments and the birth via, it was calculated the odds ratio thinking as a reference group the observed proportions among the adult women (from 20 years old on), with suitable presence to prenatal and who were submited to the vaginal bith. The adolescents birth proportion, about 21% of the births, presented a few variations on the period, following the national values. The specific tax of fecundity in the adolescence, that variated from 3,01 to 2,02 in 100 women. It was different of the correspondent values that were observed in the country, it presented lower taxes and decreasing tendency. The adequate frequency to prenatal with proportion that, in general, was low among the parturients, variated from 39,45% to 44,80% among the adults, there were lower proportions among the adolescents. It was followed by a little tendency to decrease during the period. In relation to the kind of birth, in which, it is important the higher values of vaginal birth among the adolescents, as it was expected, it called attention to the meaningful presence of resource to the cesareans in this segment. The prematurity proportions, low weight at the birth and apgar at the 5th minute beneath seven, were superior among the adolescentsin general. These values achieved, respectively, 24.00%, 34.00% and 6.00% in the precocious adolescence during 2001. If the proportions of the adolescents birth occurrence were to seemed to the ones of the country, countering the study hypothesis, the specific taxes of fecundity during the adolescence were lower and they presented descendent tendency. Data, related to the characterization of the parturients and the ending of their pregnancies, pointed to a higher frequency of its occurrence among adolescents, despite of the weak intensity of the associations with age, confirming the expectations that were explicited during this study. Controling these relations by the presence to the prenatal appointments and the birth via, however, the odds ratio evidenced the different occurrence chances of the signed endings in the distinguished age groups. Pointing to the protector character of the prenatal and the normal birth, about the endings, the suspicions were not put apart from the existence of an intrinsic risk of difficulties associated to the age, especially in the precocious adolescence. It is confirming the investigation hypothesis to the bigger proportions of the prematurity, low weight when the baby borns and the apgar at the 5th minute beneath the seven in the adolescence. In this case, although the specific taxes of fecundity in Montes Claros, on the considered groups, were lower than the ones of the country, presenting even the descendent tendency in the period, it is not possible to ignore the pregnancy occurrrence during the adolescence in this region, especially from 10 to 14 years old, it is by the volume, it is by the im-plications it brings.BV UNIFESP: Teses e dissertaçõe