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Semin Reprod Med 2022; 40(01/02): 116-123
DOI: 10.1055/s-0041-1735847
Review Article

Social Determinants of Health and Adverse Outcomes in Adolescent Pregnancies

S. Amjad
1   Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
,
M. Adesunkanmi
1   Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
,
J. Twynstra
2   School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada
,
J.A. Seabrook
2   School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada
3   Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
4   Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
5   Children's Health Research Institute and Lawson Health Research Institute, London, Ontario, Canada
,
M.B. Ospina 
1   Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
› Author Affiliations Funding Women and Children's Health Research Institute Canada Research Chairs 950-232833.
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Abstract

The association between adolescent childbearing and adverse maternal and birth outcomes has been well documented. Adverse adolescent pregnancy outcomes are associated with substantial risk of long-term morbidities for the young mother and their newborns. Multiple levels of social disadvantage have been related to adverse pregnancy outcomes among adolescent mothers. Patterns of cumulative social adversity define the most marginalized group of adolescents at the highest risk of experiencing adverse maternal and birth outcomes. Using a social determinants of health (SDOH) framework, we present an overview of the current scientific evidence on the influence of these conditions on adolescent pregnancy outcomes. Multiple SDOH such as residence in remote areas, low educational attainment, low socioeconomic status, and lack of family and community support have been linked with increased risk of adverse pregnancy outcomes among adolescents. Based on the PROGRESS-Plus equity framework, this review highlights some SDOH aspects that perinatal health researchers, clinicians, and policy makers should consider in the context of adolescent pregnancies. There is a need to acknowledge the intersectional nature of multiple SDOH when formulating clinical and societal interventions to address the needs of the most marginalized adolescent in this critical period of life.

Keywords

social determinants of health - adolescent - pregnancy - adverse birth outcomes


Publication History

Article published online:
09 September 2021

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