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      Mental health outcomes beyond the post-partum period among adolescent mothers: a systematic review and meta-analysis

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          ABSTRACT

          Background:

          Adolescence is the most crucial part of life. The vulnerability of adolescent mothers is even more pronounced and can affect various health aspects. While they suffer from social and emotional stresses shortly after giving birth, the long-term effect after the post-partum period of adolescent pregnancy on the mental outcomes holds prime importance. Thus, this systematic review aims to ascertain the association between adolescent pregnancy on mental health outcomes.

          Methods:

          The search strategy was run in June 2023 on databases including PubMed, CINAHL, Scopus, Psych Info, and Embase . Quality assessment of the studies was done using the National Institute of Health (NIH)’s National Heart, Lung and Blood Institute (NHLBI) tool for observational studies. For studies that measured similar outcomes, a meta-analysis was conducted.

          Findings:

          The search strategy yielded 21 results from all databases and cross-referencing. Of these, all except for one (case–control) were cross-sectional and cohort studies. The pooled analysis found a significant association between adolescent pregnancy and depression (RR 1.34; 95% CI 1.05, 1.72, 6 studies, heterogeneity: Chi 2 P 0.01; I 2 = 60%); however, no association was found in anxiety (RR 1.05; 95% CI 0.26, 4.14, 2 studies; heterogeneity: Chi² P = 0.0003; I 2 = 93%) and suicidal ideation (RR 3.21; 95% CI 0.17, 59.33; 3 studies; heterogeneity: Chi 2 P < 0.00001; I 2 = 98%).

          Implication:

          These findings suggest that the mental health needs of adolescent mothers must be addressed and innovative and effective interventions that support and address the mental health needs of adolescent mothers are needed to improve their mental health.

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          Most cited references59

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            RoB 2: a revised tool for assessing risk of bias in randomised trials

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              Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review.

              To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low- and lower-middle-income countries. Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included. Thirteen papers covering 17 low- and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8%) countries, and on disorders in the postnatal period, for 17 (15%). Weighted mean prevalence was 15.6% (95% confidence interval, CI: 15.4-15.9) antenatally and 19.8% (19.5-20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1-13.2); unintended pregnancy (1.6-8.8); being younger (2.1-5.4); being unmarried (3.4-5.8); lacking intimate partner empathy and support (2.0-9.4); having hostile in-laws (2.1-4.4); experiencing intimate partner violence (2.11-6.75); having insufficient emotional and practical support (2.8-6.1); in some settings, giving birth to a female (1.8-2.6), and having a history of mental health problems (5.1-5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95% CI: 0.4-1.0); being of the ethnic majority (OR: 0.2; 95% CI: 0.1-0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95% CI: 0.3-0.9). CPMDs are more prevalent in low- and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history.
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                Author and article information

                Journal
                Health Psychol Behav Med
                Health Psychol Behav Med
                Health Psychology and Behavioral Medicine
                Routledge
                2164-2850
                31 January 2024
                2024
                31 January 2024
                : 12
                : 1
                : 2305741
                Affiliations
                [a ]Internal Medicine, Aga Khan University Hospital , Karachi, Pakistan
                [b ]Dean’s Office, Medical College, Aga Khan University , Karachi, Pakistan
                [c ]Community Health Sciences, Aga Khan University , Karachi, Pakistan
                [d ]Adelaide Medical School, The University of Adelaide , Adelaide, Australia
                [e ]Public Health Information Development Unit, Torrens University Australia , Adelaide, Australia
                [f ]Faculty of Nursing, University of Alberta , Edmonton, Canada
                [g ]Adelaide Medical School, Robinsons Research Institute University of Adelaide , Adelaide, Australia
                [h ]Faculty of Health and Medical Sciences, School of Public Health, University of Adelaide , Adelaide, Australia
                Author notes
                [CONTACT ] Zohra S. Lassi Zohra.lassi@ 123456adelaide.edu.au Adelaide Medical School, Robinsons Research Institute , University of Adelaide , Australia; Faculty of Health and Medical Sciences, School of Public Health, University of Adelaide, Australia

                Supplemental data for this article can be accessed online at https://doi.org/10.1080/21642850.2024.2305741.

                Article
                2305741
                10.1080/21642850.2024.2305741
                10836488
                38313449
                cade7153-0ba7-4b96-a4cc-89484ada8b1b
                © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

                History
                Page count
                Figures: 2, Tables: 5, Equations: 0, References: 66, Pages: 25
                Categories
                Review Article
                Review Article

                adolescent,depression,mental health,teenage pregnancy,post-partum

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