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Biomedical subjects

C Stevens-Simon

Publications and source records attributed to C Stevens-Simon.

At least 55 records · Page 3Linked to original sources
PubMed1993

Self-perception of infertility among female adolescents.

OBJECTIVE: To determine the prevalence and correlates of the self-perception of infertility among female adolescents. DESIGN: Cross-sectional survey. SETTING: Urban adolescent clinic in a neighborhood health center in Denver, Colo. PARTICIPANTS: Two hundred sexually active, nulliparous, 14- through 18-year-old female adolescents. MEASUREMENTS/MAIN RESULTS: Concerns about fertility were expressed by 43 (21.5%) of the 200 respondents. Logistic regression analysis revealed that the factors most strongly associated with the self-perception of infertility were as follows (odds ratios; 95% confidence interval): a history of discussing infertility with anyone (4.3; 1.8 to 10.4); desire for pregnancy (3.8; 1.4 to 10.3); boyfriend desiring pregnancy (3.0; 1.1 to 8.3); a history of sexually transmitted disease(s) (3.0; 1.2 to 7.1); and having an older boyfriend (2.6; (1.1 to 6.2). Adolescents who doubted their fertility used contraceptives less frequently than other teens (30% vs 55% of the time; P < .01). CONCLUSIONS: The self-perception of infertility is common among sexually active urban female adolescents and may pose another barrier to contraceptive use. Our findings may help clinicians counsel adolescents about contraceptives more effectively.

Adolescent↗
PubMed1993

Skeletal maturity and growth of adolescent mothers: relationship to pregnancy outcome.

The purpose of this study was to evaluate the relationship between postpartum maternal bone age and the incidence of obstetric and neonatal complications in adolescent pregnancies. Bone age determinations were obtained on 93 poor, black 12- through 18-year-old adolescents during the puerperium. Results showed maternal bone ages ranging from 15 to 18 years; bone age was less than 18 years in 64 (68.8%) of the 93 adolescent mothers we studied. Maternal bone age correlated significantly with maternal chronologic age (r = 0.70) and prepregnant body size (r = 0.25) but did not correlate with total maternal weight gain and growth during pregnancy, the incidence of obstetric and neonatal complications, or infant birth weight and gestational age. Our findings suggest that many young, pregnant adolescents have the potential to grow during and after pregnancy, but do not support the hypothesis that ongoing maternal growth is an obstetric risk factor during adolescence.

Adolescent↗
PubMed1993

Factors associated with preterm delivery among pregnant adolescents.

The purpose was to identify characteristics of pregnant adolescents associated with preterm delivery. We studied 126 poor, black, 12 through 18-year-old pregnant adolescents and compared the prevalence of potentially high-risk maternal characteristics and obstetric complications in those who bore preterm and term infants. Of the adolescents studied, 12 (9.5%) delivered prematurely. Five maternal characteristics--conception within 3 years of menarche, a low body mass index, a past history of physical or sexual abuse, a socially deviant father of the baby, and vaginal bleeding during the first 8 weeks of gestation--were associated with preterm delivery. A theoretical model is proposed and the therapeutic implication of the study findings.

Adolescent↗
PubMed1993

Weight gain attitudes among pregnant adolescents.

Maternal weight gain is the most important, manageable determinant of infant birth weight among adolescents. Negative attitudes toward weight gain may adversely affect maternal weight gain. We hypothesized that (a) negative attitudes toward pregnancy weight gain are more common among younger pregnant adolescents, and (b) negative attitudes toward pregnancy weight gain adversely affect adolescent maternal weight gain. The study subjects, 99, radially diverse, pregnant 13 through 18 year olds, completed the 18-item, Likert-format, Pregnancy and Weight Gain Attitude Scale. Responses to the questionnaire indicated that most (83.8%) of the adolescents we interviewed had a positive attitude toward pregnancy weight gain when they entered prenatal care. Univariate analyses revealed that attitudes toward weight gain were unrelated to the respondents' ages but inversely related to their prepregnant weights (-0.16; p = 0.06) and the severity of their symptoms of depression (r = -0.26; p = 0.004). Attitudes toward weight gain were also directly related to their family support (r = 0.17; p = 0.06). Weight gain was significantly related to 4 of the 18 scale items but not to the total attitude scale score. We conclude that (a) the developmental task of formulating a positive body image does not foster more negative attitudes toward pregnancy weight gain among younger adolescents; (b) negative weight gain attitudes are most common among heavier adolescents, depressed adolescents, and adolescents who do not perceive their families as supportive; and (c) negative weight gain attitudes could adversely affect pregnancy weight gain.

Adolescent↗
PubMed1993

Clinical applications of adolescent female sexual development.

Growth and development during the teenage years encompass two closely related maturational phenomena: 1) puberty, the process of physical growth and development, and 2) adolescence, the process of cognitive and psychosocial growth and development. Puberty and adolescence usually proceed in an orderly, predictable sequence. Knowledge of the usual sequence of adolescent physical and psychosocial development is critical for distinguishing normal developmental processes from pathologic conditions. Providing effective anticipatory guidance to adolescents and their parents requires an understanding of the wide range of normal adolescent behavior and the ability to identify young people who are not developing normally.

Adolescent↗
PubMed1993

Adolescent gestational weight gain and birth weight.

OBJECTIVE: To examine the relationship among maternal age, prepregnancy weight, gestational weight gain, and birth weight in 141 low-income black adolescents and their infants. STUDY SAMPLE: One hundred forty-one consecutively enrolled, low-income, black adolescents who entered prenatal care prior to their 23rd week of gestation, were free of chronic diseases, took no regular medications, had no known uterine anomalies, and gave birth to one live neonate. RESULTS: After controlling for prepregnancy weight and other potentially confounding variables, we found a significant relationship between gestational weight gain and infant birth weight among younger adolescents (< 16 years old at conception), but not among older adolescents (16 through 19 years old at conception); younger adolescents contributed more of their gestational weight gain to their fetuses than did older adolescents. Among younger adolescents the rate of maternal weight gain during the entire gestation was significantly correlated with birth weight (r = .40; P < .01), whereas for older adolescents only maternal weight gain during the second half of gestation was significantly correlated with birth weight (r = .25, P < .05). CONCLUSIONS: The data do not support the thesis that younger/adolescents compete with their fetuses for nutrients; in fact, younger study adolescents transferred more of their gestational weight gain to their fetuses than did older adolescents.

Adolescent↗
PubMed1992

Adolescent pregnancy. Gestational weight gain and maternal and infant outcomes.

OBJECTIVE: To clarify the advantages and disadvantages of large gestational weight gain among pregnant adolescents. DESIGN: Prospective, longitudinal survey. SETTING: Adolescent-oriented maternity program in Rochester, NY. PARTICIPANTS: One hundred forty-one poor, black, pregnant 12- through 19-year-olds grouped according to rate of gestational weight gain. Slow weight gain was defined as weight gain of less than 0.23 kg per week; average, 0.23 to 0.4 kg per week; and rapid, more than 0.4 kg per week. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Infants of rapid weight-gainers were significantly larger than infants of slower weight-gainers but did not experience fewer perinatal complications than other infants. Infants of slow weight-gainers were significantly smaller than infants of average and rapid weight-gainers and experienced more perinatal complications than other infants. Adolescents who gained weight rapidly retained more weight and, therefore, were more often obese after pregnancy. CONCLUSIONS: The advantages of large weight gains for pregnant adolescents and their infants are well-documented; this study demonstrates the importance of balancing the long-term potential morbidity of maternal obesity against the benefits of enhanced fetal growth in formulating weight-gain recommendations for pregnant adolescents.

Adolescent↗
PubMed1992

Tangible differences between adolescent-oriented and adult-oriented prenatal care.

Comprehensive prenatal care reduces many of the risks associated with adolescent childbearing. To learn why this intervention strategy is successful, we compared the care received by 123 poor, black, younger than 19-year-olds in an adolescent-oriented prenatal program to that received by 72 sociodemographically similar, black, 19-30-year-olds in a university hospital-based prenatal clinic. We found that adolescents entered care later (13.6 +/- 5.6 vs. 11.7 +/- 3.4 weeks; p less than 0.01) and were less likely to obtain an adequate quantity of care then were adults (45.5% vs. 61.1%; p = 0.04). However, teens were enrolled in the Women, Infant, and Children (WIC) food supplement program more rapidly than adults (within 7 +/- 6 vs. 10 +/- 6 weeks of the first prenatal visit; p = 0.002), were referred more often to community service agencies for help with nonobstetric, psychosocial, and financial problems (37.4% vs. 18.3%; p less than 0.0001), and were tested and treated more frequently for sexually transmitted diseases (p less than 0.0001). When the adolescents entered care they were smaller, had lower hematocrits, more social and behavioral problems, poorer diets, and more sexually transmitted diseases than did the adults. Later in gestation, however, hematocrits, diets, weight gain, and birth outcomes were similar in the two groups. The implications of these findings for health care providers and for further research are discussed.

Adolescent↗
PubMed1992

School-based prenatal and postpartum care: strategies for meeting the medical and educational needs of pregnant and parenting students.

Adolescent pregnancy is not a new phenomenon, but it is a source of concern to U.S. educators because of the many young women choosing to become parents and the profound effect early childbearing has on the educational and vocational careers of many young Americans. Strategies for addressing the unique medical, educational, and psychosocial needs of pregnant and parenting students will be examined. Documented physical and psychosocial risks associated with adolescent childbearing will be reviewed, and data related to the effect of young maternal age on pregnancy outcome and the effect of pregnancy on the life course development of adolescents will be emphasized. Specific elements of comprehensive, adolescent-oriented prenatal and postnatal care will be discussed, as well as the effectiveness of existing prenatal and postnatal programs at preventing the most serious sequelae of adolescent childbearing. The role of school-based services will be examined, and ways will be discussed for educators and health care providers to collaborate in providing medical, educational, and social services for adolescent parents and their children. In addition, topics for future research will be suggested.

Adolescent↗
PubMed1992

Determinants of weight gain in pregnant adolescents.

Maternal weight gain is the most important modifiable determinant of infant birth weight. Effective intervention requires an understanding of the factors that influence the amount of weight women gain during pregnancy. We studied the dietary, health, and social habits of 141 poor, black, 12- to 19-year-old prenatal patients to learn more about the determinants of weight gain among pregnant adolescents. The patients were divided into three weight gain groups: slow (n = 23): less than 0.28 kg/week; average (n = 87): 0.28-0.45 kg/week; and rapid (n = 31): more than 0.45 kg/week. The results of logistic regression analysis revealed two statistically significant predictors of slow weight gain: the consumption of fewer than three snacks per day and delayed (third trimester) enrollment in the Supplemental Food Program for Women, Infants, and Children. By contrast, rapid gainers were more compliant with prenatal visits and reported more depressive symptoms and alcohol consumption than did other study subjects. We conclude that attention to these modifiable correlates of inadequate and excessive weight gain may enable dietitians and other health care providers to develop more effective strategies for promoting optimal weight gain among pregnant adolescents.

Adolescent↗
PubMed1991

Exacerbation of fibrous dysplasia associated with an adolescent pregnancy.

Fibrous dysplasia is a metabolic skeletal disorder in which the medullary spaces of affected bones are replaced by fibro-osseous tissue. Patients with fibrous dysplasia usually become symptomatic during childhood; the adolescent patient we describe is unusual because she was not known to suffer from fibrous dysplasia until she became pregnant and experienced a dramatic reactivation of the symptoms. The therapeutic implication of this case and reproductive counselling for young women with fibrous dysplasia are discussed.

Adolescent↗
PubMed1991

Early vaginal bleeding, late prenatal care, and misdating in adolescent pregnancies.

Vaginal bleeding early in pregnancy may be mistaken for menstrual bleeding and delay entry into prenatal care by delaying the diagnosis of pregnancy. This study tests the hypotheses that (1) more adolescents report early first-trimester vaginal bleeding than do adults and (2) a history of vaginal bleeding is associated with later entry into prenatal care, particularly among adolescents. Reports of early vaginal bleeding were prospectively obtained from black, predominantly primiparous, unmarried poor women (136 adolescents and 53 adults). As hypothesized, more adolescents reported early first-trimester vaginal bleeding than did adults (16.9% vs 5.7%; P less than .01). Adolescents who reported early vaginal bleeding also entered prenatal care later (16.2 weeks) than did adolescents who reported no bleeding (12.7 weeks) (P less than .03); this was not true for adults. If dating of the gestation is based solely on last menstrual period history, inflation of the incidence of preterm births to adolescents and the mean birth weights of those preterm neonates may occur. The findings suggest that new strategies focusing on the recognition of menstrual irregularities as a symptom of pregnancy may be needed to promote early prenatal care among adolescents. Additionally, adolescent pregnancies should be dated by both ultrasound and Dubowitz examinations.

Adolescent↗