Perfil da adolescente grávida quanto aos aspectos sócio-demográficos, psicológicos e de saúde sexual e reprodutiva
Resumo
Resumo: Este é um estudo descritivo de corte transversal, realizado na Maternidade do Hospital de Clínicas da UFPR, no período de Io de maio a 30 de novembro de 1999. Os objetivos desta pesquisa foram analisar o perfil das adolescentes grávidas quanto aos aspectos sócio-demográficos, psicológicos e de saúde sexual e reprodutiva. Foram incluídas no estudo a s g estantes q ue parturiram n esse p eríodo, s elecionadas p or i dade e a o a caso, submetidas a entrevista através de questionário. De um total de 1416 gestantes que deram à luz, foram entrevistadas 614 (43,36%), sendo constituídos dois grupos: o de estudo (1), com 216 adolescentes de 13 a 19 anos, e o controle (2), com 398 gestantes de 20 a 29 anos. A análise estatística consistiu na utilização de programa da UFPR (Software Estatística) para organização dos dados, teste t de Student, teste Qui- Quadrado de Pearson e teste exato de Fisher, com nível de significância de 5%. As adolescentes apresentaram melhor escolaridade (p=0,013), menor número de parceiros (p<0,001), companheiros mais velhos, maior número de solteiras (p<0,01), 58,8% não estudavam, 49,4% deixaram de estudar, 75% não trabalhavam (p<0,01), 48,3% deixaram de trabalhar, renda familiar média de 1,9 salários mínimos (p<0,01), antecedente de mãe adolescente (p=0,0053), 61,6% não desejavam a gravidez (p<0,001), 76,4% eram primigestas, com sexarca aos 15,8 anos (p<0,0001), idade média do primeiro filho aos 16,7 anos (p<0,05), maior conhecimento de métodos anticoncepcionais, 30,1% evitavam a gravidez ao engravidar. Não houve diferença estatística quanto à idade da menarca e realização de pré-natal. Conclui-se que o perfil das adolescentes revelou, quanto aos aspectos sócio-demográficos, que elas engravidaram em média aos 17 anos, a maioria estava em união estável antes de engravidar, com companheiros mais velhos, tiveram menor número de parceiros, tinham baixa escolaridade (porém, melhor que a das adultas), já não estudavam à época da concepção e, cerca de metade que freqüentava a escola, abandonaram os estudos. Tinham menor renda familiar, maior dependência em relação à família e entre as que trabalhavam (cerca de Và), metade abandonou sua atividade laborativa. Quanto aos aspectos psicológicos, o relacionamento com os pais era bom, sendo melhor com a mãe. As adolescentes tiveram maior proporção de mães adolescentes e de gestação indesejada. Em relação à saúde sexual e reprodutiva, a maioria era primigesta, ao contrário das adultas, em que a predominância foi de multiparidade. Entretanto, % das adolescentes, foi de multíparas. Não houve diferenças entre a idade média da menarca entre os grupos, porém a sexarca foi mais precoce nas adolescentes. Entre as adultas, a maioria teve o primeiro filho também na adolescência. As adolescentes tinham maior conhecimento de métodos contraceptivos e, mesmo não desejando a gravidez, a maioria não utilizava nenhum método. Não houve diferenças entre os grupos quanto à realização e número de consultas pré-natal. Abstract: This is a cross-sectional, descriptive study carried out in the Maternity of the Hospital de Clínicas, Federal U niversity of Paraná, during the period May 1 - November 3 0, 1999. The objectives of this study were to analyze the profile of pregnant adolescents from a sociodemographic and psychological viewpoint, as well as analyzing aspects related to sexual and reproductive health. Pregnant women, expected to give birth during that period, were randomly selected and allocated to one of two groups according to a ge. W omen e nrolled t o t he s tudy w ere s ubmitted t o a n i nterview c arried o ut b y means of a questionnaire. From a total of 1,416 pregnant women who gave birth in the hospital during that period, 614 (43.36%) were interviewed and allocated to one of two groups: 1) the adolescent group aged 13-19 years (n=216) or 2) the control group of pregnant women aged 20-29 years (n=398). Data entry was carried out using a statistical software program created at the Federal University of Paraná. Student's t- Test, Pearson's Chi-Square Test and Fisher's Exact Test were used for the statistical analysis of data. Significance level was fixed at 5%. Results showed that women in the adolescent group had more years of schooling (p=0.013), fewer sexual partners (p<0.001) and older partners than women in the control group. There were more single women in the adolescent group (p<0.01), 58.8% were not studying at that time, 49.4% had abandoned their studies, 75% did not work (p<0.01), and 48.3% had been working but had stopped. The adolescent group had a lower mean family income of 1.9 minimum wages (p<0.01), were more likely to have had an adolescent mother (p=0,0053), 67.6% had not wanted the pregnancy (pO.OOl) and 76.4% were primigravidas. Mean age at first sexual intercourse was 15.8 years (pO.OOOl). Mean age at birth of first child was 16.7 years (p<0.05). Women in this group had a greater knowledge of contraceptive methods and 30.1% were practicing some form of contraception when they became pregnant. There was no statistically significant difference in age at menarche and in prenatal care between the two groups. In conclusion, with regard to sociodemographic aspects, the profile of these adolescents revealed that they became pregnant at a mean age of 17 years, the majority was in a stable union with older partners before becoming pregnant, they had fewer partners than the adult women, an education level which was low but better than that of the group of adult women, they were no longer studying at the time of conception, and approximately half of those who were attending school abandoned their studies. They had a lower family income, greater dependence on the family, and among those who were working (around 25%), half abandoned their job. With respect to the psychological aspects o f t he s tudy, t heir r elationship w ith t heir p arents was good, p articularly w ith their mother. A greater proportion of the adolescents had been born to adolescent mothers and had not desired the current pregnancy. With regard to sexual and reproductive health, the majority of adolescents were primigravidas, unlike the adults in the control group, in which multiparity was predominant. However, 25% of the adolescents were multiparas. There was no statistically significant difference in the mean age at menarche between the two groups, although first sexual intercourse occurred earlier in the group of adolescents. In the adult group, the majority had also had their first child during adolescence. The adolescents were more knowledgeable regarding contraceptive methods and, although they had not wanted to become pregnant, the majority had not been using any method of contraception. There was no statistically significant difference between the groups with regard to prenatal care.
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