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Wellcome Open Res. 2018 May 21;3:62. doi: 10.12688/wellcomeopenres.14613.1. eCollection 2018.

Trends and birth outcomes in adolescent refugees and migrants on the Thailand-Myanmar border, 1986-2016: an observational study.

Author information

1
Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Un, Mahidol University, Mae Sot, 63110, Thailand.
2
Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, Irvine, California, USA.
3
Karen Refugee Committee, Mae Sot, Thailand.
4
Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, 10400, Thailand.
5
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
6
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Oxford, OX3 7FZ, UK.

Abstract

Background: Currently there are more adolescents (10-19 years old) and young adults (20-24 years old) than ever. Reproductive health among this age group is often overlooked, although it can have a profound impact on the future. This is especially the case in conflict zones and refugee settings, where there is a heightened need for reproductive health care, and where both the resources and possibility for data collation are usually limited. Methods: Here we report on pregnancies, birth outcomes and risk factors for repeat pregnancies among adolescent and young adult refugees and migrants from antenatal clinics on the Thailand-Myanmar border across a 30 year time span. Results: Pregnancy and fertility rates were persistently high. Compared with 20-24-year-olds, 15-19-year-olds who reported being unable to read had 2.35 (CI: 1.97 - 2.81) times the odds for repeat pregnancy (gravidity >2). In primigravidae, the proportion of small for gestational age (SGA) and preterm births (PTB), and neonatal deaths (NND) decreased with increasing maternal age (all p <0.001). After adjustment, this association retained significance for PTB (cut-off point, ≤18 years) but not for SGA and NND. Conclusions: There is considerable room for improvement in adolescent pregnancy rates in these border populations, and educational opportunities may play a key role in effective interventions.

KEYWORDS:

adolescent pregnancy; teenage pregnancy; reproductive health; birth outcomes; pregnancy trend; pregnancy outcomes; refugee health; migrant health

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