Teenage parenthood : paternal characteristics and child health outcomes
Sammanfattning: This thesis had two general aims. The first was to describe and compare the social-economic and reproductive characteristics and involvement in pregnancy and childbirth of fathers of children born to teenage mothers in Stockholm (Papers I and II). The second aim was to study the risk of long-term morbidity in children born to teenage mothers, measured as injuries in pre-school children (Paper III) and psychiatric morbidity in adolescence and young adulthood (Paper IV). Methods: Papers I and II are descriptive comparative studies, based on the same study population and on the same instrument. Data were collected with questionnaires in 132 fathers of children born to teenage mothers and 132 fathers of children born to primiparas aged 25-29 years. All fathers were present on postnatal wards in Stockholm between May 1997 and April 1998. Papers III and IV are national cohort studies based on Swedish national registers. The study population in Paper III comprised all 800.190 children born in Sweden during 1987-93 who were followed prospectively in registers from birth to their seventh birthday regarding hospital admissions for unintentional and violent injuries. The study population in Paper IV included the 292.129 children born to primiparas in 1973-79. This group was followed prospectively during 1987-2002 regarding hospital admissions for substance abuse, suicide attempts, suicide deaths and schizophrenia. Results Papers I and II: A significantly larger proportion of fathers of children born to teenage mothers (Group A) compared to fathers in the control group (B), had a compromised social situation, including unstable family backgrounds, low educational attainment, illicit drug use and involvement in criminal activities. In addition, the Group A fathers more often had their sexual debut before 15 years of age and participated less in the family classes. Papers III and IV. After adjustments for social background factors, the pre-school children of teenage mothers had a 40 % increased risk for unintentional injury and a doubled risk for violent injuries compared to the children of older mothers. Also in a long-term perspective, the children of teenage mothers had an increased risk of substance abuse, suicide attempts and suicide deaths. In. contrast, the children of the oldest parents had the highest risk for schizophrenia. Conclusions: Many fathers of children born to teenage mothers showed problem behaviours, which may negatively influence their ability to engage in successful parenting. Owing to the findings of use of illicit drugs and violent crimes among the fathers and the increased risk of injuries in early childhood among the children of teenage mothers, we suggest that midwives should consider asking the teenage women about inflicted violence in early pregnancy. Moreover, midwives should consider developing separate family classes for young parents and also encouraging the expectant fathers to participate. This recommendation is also related to the finding of the increased risk of injury and psychiatric morbidity in the children of teenage mothers, which indicates that young parents might need intense information and education concerning child development and parenting in general. Owing to the findings of an increased risk for injury in the pre-school children of teenage mothers, we suggest that young parents should be given priority in injury prevention programmes.
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