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      Unintended Pregnancies in Brazil - A Challenge for the Recommendation to Delay Pregnancy Due to Zika

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          Abstract

          Because of the potential link between the ongoing Zika virus outbreak and a surge in the number of cases of congenital microcephaly, officials in Latin America have recommended that women postpone pregnancy until this association is firmly established or the outbreak subsides. However, in all these countries a large proportion of babies are still born out of unplanned pregnancies. Teenage girls are particularly at high risk, as they often lack access to preventive contraception methods, or the knowledge to use them appropriately. To gauge the magnitude of the barriers preventing the implementation of such a recommendation in Brazil, the country so far most affected by the Zika epidemic, we evaluated pregnancy rates in teenage girls, and their spatial heterogeneity in the country, in recent years (2012-2014). Nearly 20% of children born in Brazil today (~560,000 live births) are by teenage mothers. Birth incidence is far higher in the tropical and poorer northern states. However, in absolute terms most births occur in the populous southeastern states, matching to a large extent the geographic distribution of dengue (an indicator of suitable climatic and sociodemographic conditions for the circulation of Aedes mosquitoes). These findings indicate that recommendation to delay pregnancy will leave over half a million pregnant adolescents in Brazil vulnerable to infection every year if not accompanied by effective education and real access to prevention.

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          Author and article information

          Contributors
          Journal
          PLoS Curr
          PLoS Curr
          PLoS Curr
          plos
          PLoS Currents
          Public Library of Science (San Francisco, USA )
          2157-3999
          16 March 2016
          : 8
          : ecurrents.outbreaks.7038a6813f734c1db547240c2a0ba291
          Affiliations
          Wolfson College, Oxford University, Oxford, Oxfordshire, United Kingdom
          National Institute of Pure and Applied Mathematics (IMPA), Rio de Janeiro, Brazil
          Department of Global Health, George Washington University, Milken Insittute School of Public Health, Washington DC, Maryland, USA
          Laboratory for Human Evolution Studies, Genetics and Evolutionary Biology, University of São Paulo, São Paulo, Brazil
          Article
          10.1371/currents.outbreaks.7038a6813f734c1db547240c2a0ba291
          4866532
          1b8360e9-e996-482a-a810-335948cf9bc9
          © 2016 Schuck-Paim, López, Simonsen, Alonso, et al

          This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.

          History
          Funding
          LS is funded by a Marie-Curie EU grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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          Uncategorized
          aedes,brazil,microcephaly,pregancy,teenagers,zika
          Uncategorized
          aedes, brazil, microcephaly, pregancy, teenagers, zika

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