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Study objectives: The aim of this article is to describe the problem of pregnancy in girls under 15 years of age in the Dominican Republic in the period 2000-2021, to develop a specific indicator for this age group and describing the related factors. Methods: This is an exploratory ecological study, based on secondary data sources, such as birth records from the National Statistics Office (NSO) and the Ministry of Public Health (MPH). We calculated the rates of fertility and pregnancy in early adolescence, as well as analyzed their main determining factors and consequences. Results: Fertility Rate in Early Adolescence (FREA) decreases from 6.27 to 1.04 per thousand in the period 2001-2021. The average FREA for 2015-2021 was 1.78. The average Estimated Rate of Pregnancy in Early Adolescence (ERPEA) for the same period was 3.39. Disability-Adjusted Life Years (DALYs) were 11,620 years. Years of Life Lost (YLL) were 9,665.9 years. The prevalence of Low Birth Weight (LBW) in the under 15-year-old age group was 14.2 %. Conclusions: Pregnancy in childhood implies risks for both the mother and the child, including low birth weight. The official fertility rate is substantially underreported (2.84 vs. 1.79).The fertility rate indicator traditionally used does not accurately measure the number of pregnancies in women, particularly in specific age groups or populations where pregnancies may be interrupted by various factors. Therefore, the use of ERPEA is recommended.We emphasize the need for implementing the proposed indicator for the target group, as well as monitoring Sustainable Development Goal indicator 3.7.2.

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The lack of economic resources has a negative effect on the maternal role of younger mothers. In Chile, the majority of adolescent pregnancies occur in socially and economically vulnerable contexts. The current study aimed to examine the relationship between demographic variables within the family context and parenting behaviors among Chilean adolescent mothers (including affection, responsiveness, encouragement, and teaching). These factors were correlated with communication, problem-solving abilities, and personal-social development in typically developing infants. The study included a sample of 79 Chilean adolescent mother-child dyads with children aged 10 to 24 months. Communication, problem-solving, and personal-social development were assessed using the Ages and Stages Questionnaire-3, along with a demographic information questionnaire. The parenting behaviors mentioned above were observed using the Spanish version of Parenting Interactions with Children: Checklist of Observations Linked to Outcomes. The findings indicated that mothers in employment and those who had not dropped out of school had children with better problem-solving skills. Additionally, children residing with their fathers and female children performed better in communication, problem-solving, and personal-social development. Maternal responsiveness was associated with communication and problem-solving, while maternal encouragement was linked to improved problem-solving skills. Maternal teaching was connected to communication, problem-solving, and personal-social development. The study emphasized the significance of parenting and sociodemographic factors among adolescent mothers and their influence on their children's development.

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Objective. To understand the effect of digital applications on maternal and neonatal outcomes in young pregnant girls. Methods. A PubMed, CINAHL and Medline online database search was conducted, and related studies were included the databases were searched in order to carry out a more in detailed search of the available literature utilizing keywords like "digital technology"; "adolescent mothers"; and "infant, newborn", as well as Boolean operators to generate papers pertinent which were correlating with the objective of the study. Results.The findings revealed that the PPPs employed produced both positive and negative effects on mothers and newborns. Some were effective, especially in aspects related to improved mental health, while others did not necessarily support the adolescents in preparing for pregnancy and childbirth, but rather raised their anxiety levels. Similarly, the use of these apps decreased the use of emergency neonatal services by the adolescent mothers and the infants were lower in likelihood of exclusive breastfeeding. Participants appreciated the social media-based instruction, but this exposure did not translate into considerable change in routines and behaviors.

Objetivo. Conocer el efecto de las aplicaciones digitales en los resultados maternos y neonatales en jóvenes embarazadas. Métodos. Se realizó una estrategia de búsqueda en las bases de datos en línea PubMed, CINAHL y Medline utilizando los términos "digital technology"; "adolescent mothers"; y "infant, newborn", y operadores booleanos. Resultados. Los hallazgos revelaron que las APPs empleadas produjeron efectos tanto positivos como negativos sobre las madres y los neonatos. Algunas fueron efectivas, especialmente en los aspectos relacionados con la mejoría en la salud mental, mientras que otras nó ayudaron necesariamente a las adolescentes a prepararse para el embarazo y el parto, sino que más bien elevaron sus niveles de ansiedad. Del mismo modo, el uso de estas aplicaciones disminuyó la utilización de servicios neonatales de urgencia por las madres adolescentes y los neonatos tuvieron menor probabilidad de tener lactancia materna exclusiva. Las participantes apreciaron la instrucción basada en los medios sociales, pero esta exposición no se tradujo en un cambio considerable de rutinas y hábitos. Conclusión. Las soluciones digitales y basadas en la web tuvieron la capacidad de influir en los resultados de los embarazos de adolescentes, pero se requiere de otras investigaciones para evaluar hasta qué punto son útiles estos servicios de apoyo en este grupo poblacional.

Objetivo. Conhecer o efeito dos aplicativos digitais nos resultados maternos e neonatais em gestantes jovens. Métodos. Foi realizada uma estratégia de busca nas bases de dados online PubMed/Medline e CINAHL e utilizando os termos "tecnologia digital"; "mães adolescentes"; e "bebê, recém-nascido" e operadores booleanos. Resultados. Os resultados revelaram que os APPs utilizados produziram efeitos positivos e negativos nas mães e nos neonatos. Alguns foram eficazes, especialmente em termos de melhoria da saúde mental, enquanto outros não ajudaram necessariamente os adolescentes a prepararem-se para a gravidez e o parto, mas antes aumentaram os seus níveis de ansiedade. Da mesma forma, o uso desses aplicativos diminuiu a utilização de serviços neonatais de emergência por mães adolescentes e os neonatos tiveram menor probabilidade de serem amamentados exclusivamente. Os participantes apreciaram a instrução baseada nas redes sociais, mas esta exposição não se traduziu em mudanças consideráveis nas rotinas e hábitos. Conclusão. As soluções digitais e baseadas na web tiveram a capacidade de influenciar os resultados da gravidez na adolescência, mas são necessárias mais pesquisas para avaliar até que ponto estes serviços de apoio são úteis neste grupo populacional.

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The aim of this study was to describe the relationship between low-income Chilean adolescent maternal playfulness and mothers' non-intrusiveness in their children's development and to analyze whether a mother's non-intrusiveness mediates the relationship between maternal playfulness and children's development. The Parental Playfulness Scale and the Subscale of Intrusiveness from the Early Head Start Research and Evaluation Project were used to assess maternal playfulness and mothers' non-intrusiveness respectively. Ages and Stages Questionnaire 3rd Edition (ASQ-3) was applied to measure the children's communication, gross and fine motor skills, problem-solving and personal-social development. The sample consisted of 79 mother-child dyads with children aged 10-24 months (M = 15.5, SD = 4.2) and their mothers aged 15-21 years old (M = 19.1, SD = 1.7). A bivariate analysis showed that maternal playfulness was significantly associated with communication, fine motor, problem-solving and personal-social development. Moreover, higher levels of communication, fine motor skills and problem-solving development were observed in the children of less intrusive mothers. Maternal playfulness had a significant effect on children's development of language, problem-solving and personal-social skills when their mothers showed less intrusiveness during interaction. These findings contribute to the understanding of the interaction between adolescent mothers and their children. Active play and less intrusiveness can enhance child development.

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El objetivo de este trabajo es identificar y discutir los argumentos científicos y bioéticos que justifiquen el aborto terapéutico en niñas y adolescentes menores de 15 años. Para ello se hizo búsqueda bibliográfica no sistemática en fuentes nacionales y extranjeras en las diferentes indexadoras. Se encontró que existe suficiente evidencia de carácter científico que identifica al embarazo no intencional en niñas y adolescentes menores de 15 años como una urgencia médica y de alto riesgo por las diferentes complicaciones severas que se pueden dar y argumentos de carácter bioético en favor del aborto terapéutico. En conclusión, las evidencias científicas y los argumentos bioéticos sustentan suficientemente la atención del aborto terapéutico en niñas y adolescentes menores de 15 años.

The objective of this paper is to identify and discuss the scientific and bioethical arguments that justify therapeutic abortion in girls and adolescents under 15 years of age. For this purpose, a non-systematic bibliographic search was made in national and foreign sources in the different indexers. It was found that there is sufficient scientific evidence that identifies unintended pregnancy in girls and adolescents under 15 years of age as a medical emergency and of high risk due to the different severe complications that can occur and bioethical arguments in favor of therapeutic abortion. In conclusion, scientific evidence and bioethical arguments sufficiently support therapeutic abortion care for girls and adolescents under 15 years of age.

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Parents' academic socialization of their young children is a critical yet understudied area, especially in the context of vulnerable parent-child dyads. The current longitudinal study examined factors that informed mothers' beliefs and practices concerning children's kindergarten readiness in a sample of 204 Mexican-origin adolescent mothers (M age = 19.94). Adolescent mothers' individual characteristics and assets (i.e., parental self-efficacy, educational attainment, educational utility beliefs, knowledge of child development) and sources of stress (i.e., economic hardship, coparenting conflict) were related to the importance they placed on children's social-emotional and academic readiness for kindergarten, their provision of cognitive stimulation and emotional support to their children in the home, and their enjoyment of literacy activities with their child. Moreover, adolescents' perception of parenting daily hassles emerged as a mediator in this process. Findings underscore the importance of considering Mexican-origin adolescent mothers' strengths and assets along with their unique contextual stressors as they relate to beliefs and practices that could have implications for their children's school success.

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Objective: To understand the effect of digital applications on maternal and neonatal outcomes in young pregnant girls. Methods: A PubMed, CINAHL and Medline online database search was conducted, and related studies were included the databases were searched in order to carry out a more in detailed search of the available literature utilizing keywords like "digital technology"; "adolescent mothers"; and "infant, newborn", as well as Boolean operators to generate papers pertinent which were correlating with the objective of the study. Results: The findings revealed that the PPPs employed produced both positive and negative effects on mothers and newborns. Some were effective, especially in aspects related to improved mental health, while others did not necessarily support the adolescents in preparing for pregnancy and childbirth, but rather raised their anxiety levels. Similarly, the use of these apps decreased the use of emergency neonatal services by the adolescent mothers and the infants were lower in likelihood of exclusive breastfeeding. Participants appreciated the social media-based instruction, but this exposure did not translate into considerable change in routines and behaviors. Conclusion: Digital and web-based solutions had the ability to influence adolescent pregnancy outcomes, but further research is needed to assess the extent to which these support services are useful in this Population Group.

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Resumo Estudo de casos múltiplos com objetivo de analisar a rede de apoio social de jovens mães de filhos diagnosticados com sífilis congênita. Realizado em um município do estado do Ceará com seis participantes. As informações foram coletadas mediante entrevista semiestruturada e analisadas por meio da técnica analítica da síntese cruzada dos casos. A rede social das jovens foi constituída por familiares, pessoas externas à família, equipamentos sociais do território e serviços de saúde. Constataram-se vínculos heterogêneos e o apoio social foi essencial após o diagnóstico de sífilis, no período gestacional e puerperal. A transmissão vertical da sífilis é permeada por subjetividades que podem ser identificadas a partir da compreensão do contexto que envolve redes sociais, relações interpessoais e apoio social das mães e de seus filhos.

Abstract This study of multiple cases aimed to analyze the social support network of young mothers of children diagnosed with congenital syphilis in a municipality in Ceará with six participants. Information was collected through semi-structured interviews and analyzed using the cross-case synthesis analytical technique. The young women's social network comprised family members, people outside the family, and social facilities. We identified heterogeneous bonds and social support as essential in the gestational and postpartum periods after the diagnosis of syphilis. The vertical transmission of syphilis is permeated by subjectivities identified from understanding the context involving social networks, interpersonal relationships, and support for mothers and their children.

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En los últimos tiempos, la praxis de la cesárea en los centros hospitalarios se ha incrementado notablemente, el cual es ha sido corroborado según fuentes del INEI, por su parte, la OMS estandarizó que la variabilidad máxima es el 15%, superado aquello genera un grave problema al estado en cuestiones económicos, para constatar la problemática se tuvo en cuenta el objetivo de caracterizar a las mujeres de parto por cesárea a través de variables obstétricas desde la perspectiva de Robson, por lo que la investigación correspondió al enfoque cuantitativo, tipo no experimental y diseño descriptivo, la muestra representada por 1365 mujeres registradas en el base de datos correspondientes al 2019. El análisis de los resultados obedeció al método inductivo-deductivo, la misma que permitió diferenciar la tasa global de cesárea, el modelo de Robson mostró como resultado el 53%, cifra que supera en 38% a lo que establece la OMS, mientras que los grupos con mayor contribución a la tasa global de cesáreas fueron los grupos: 5, 1, 3 y 10. Finalmente, se concluye que la mayor cantidad de las mujeres han sido sometida al parto por cesárea, siendo mayor la tasa global durante el año indicado, en consecuencia generó mayor gasto al estado, exigiendo incrementar presupuesto al sector salud, cabe precisar que existe la posibilidad de controlar a través de la inducción a las mujeres embarazadas para el parto vaginal aplicación de los métodos y técnicas eficaces que permitan generar confianza a la mayor población de mujeres gestantes.

In recent times, the practice of cesarean section in hospital centers has increased notably, which has been corroborated according to INEI sources, on the other hand, the WHO standardized that the maximum variability is 15%, exceeding this generates a serious problem for the state in economic matters, In order to verify the problem, the objective of characterizing women who give birth by cesarean section through obstetric variables from Robson's perspective was taken into account, so the research corresponded to the quantitative approach, non-experimental type and descriptive design, the sample represented by 1365 women registered in the database corresponding to 2019. The analysis of the results obeyed the inductive-deductive method, the same that allowed differentiating the global rate of cesarean section, Robson's model showed as a result 53%, a figure that exceeds by 38% what the WHO establishes, while the groups with the highest contribution to the global rate of cesarean section were the groups: 5, 1, 3 and 10. Finally, it is concluded that most women have been subjected to cesarean delivery, being higher the overall rate during the year indicated, consequently generated greater expenditure to the state, requiring increased budget to the health sector, it should be noted that there is the possibility of controlling through the induction of pregnant women for vaginal delivery application of effective methods and techniques to generate confidence to the largest population of pregnant women.

Nos últimos tempos, a prática da cesárea nos centros hospitalares tem aumentado notavelmente, o que tem sido corroborado de acordo com fontes do INEI, enquanto a OMS padronizou que a variabilidade máxima é de 15%, o que gera um grave problema para o Estado em questões econômicas, A fim de verificar o problema, foi levado em conta o objetivo de caracterizar as mulheres que dão à luz por cesárea através de variáveis obstétricas da perspectiva de Robson, de modo que a pesquisa correspondeu à abordagem quantitativa, tipo não experimental e desenho descritivo, a amostra representada por 1365 mulheres registradas no banco de dados correspondente a 2019. A análise dos resultados obedeceu ao método indutivo-dedutivo, que nos permitiu diferenciar a taxa geral de cesárea, o modelo de Robson mostrou um resultado de 53%, que é 38% maior do que o estabelecido pela OMS, enquanto os grupos com maior contribuição para a taxa geral de cesárea foram os grupos 5, 1, 3 e 10. Finalmente, conclui-se que a maioria das mulheres passou por cesarianas, sendo a taxa geral mais alta durante o ano em questão, e como resultado, o Estado gastou mais dinheiro, exigindo um aumento no orçamento do setor de saúde. Deve-se notar que é possível controlar as mulheres grávidas através da indução ao parto vaginal, aplicando métodos e técnicas eficazes que gerarão confiança na população maior de mulheres grávidas.

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Background: Low maternal self-efficacy and high levels of anxiety, depression, and stress can be triggered in adolescent mothers due to an incomplete development process that makes them physically or psychologically unprepared for the responsibilities of motherhood and parenting. These factors may be linked to difficulties with their children's social-emotional development. The present study aims to: (a) analyze the relationship between maternal self-efficacy and stress, depression, and anxiety levels in low-income adolescent mothers; (b) examine the relationship between maternal self-efficacy and well-being with children's social-emotional development; and (c) describe the effects of maternal self-efficacy on children's social-emotional development, mediated by maternal well-being. Methods: A sample of 79 dyads comprising low-income Chilean adolescent mothers aged from 15 to 21 years old (M = 19.1, SD = 1.66) and their children aged 10 to 24 months (M = 15.5, SD = 4.2) participated in this research. A set of psychometric scales was used to measure maternal self-efficacy (Parental Evaluation Scale, EEP), the mothers' anxiety and depression (Hospital Anxiety and Depression Scale, HADS), maternal stress (Parental Stress Scale, PSS), and the children's social-emotional development (Ages and Stages Questionnaire Socio-emotional, ASQ-SE). Bivariate analyses and mediation models were employed to estimate and test the relevant relationships. Results: A bivariate analysis showed that maternal self-efficacy was negatively related to the mother's anxiety, depression, and stress. Moreover, there was a significant relationship between maternal self-efficacy and maternal stress, and children's self-regulation and social-emotional development. Maternal self-efficacy, mediated by maternal anxiety, depression, and stress scores, had a significant effect on the development of children's self-regulation. Conclusions: The results confirm the importance of adolescent mothers' emotional well-being and maternal self- efficacy with respect to their children's social-emotional development. This makes it necessary to have detailed information about how emotional and self-perception status influences a mother's role in the development of her children.

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El embarazo adolescente es considerado un factor de riesgo tanto para la salud de la madre como para la de su futuro hijo por significar una doble crisis del ciclo vital, poniendo en riesgo el proceso de vinculación. Objetivos. El presente estudio busca analizar el riesgo relacional, tipo de apego y comparar la aparición de síntomas depresivos en madres adolescentes y adultas durante la gestación y en el período postparto. Métodos. Estudio prospectivo de dos cohortes de primigestas adolescentes y adultas, pertenecientes a centros de atención primaria de Valparaíso durante el año 2013. Resultados. Las madres adolescentes presentaron una mayor prevalencia de apego no seguro, mayores tasas de alto riesgo relacional materno-fetal y madre-bebé y mayor prevalencia de síntomas depresivos en comparación a madres adultas. Sin embargo, sólo la diferencia en la prevalencia de apego no seguro entre ambas cohortes fue estadísticamente significativa.

Teenage pregnancy is considered a risk factor for both the mother and her child's health and wellbeing. It can be hypothesized that going through a double psychological crisis might be harmful to the development of a secure relationship of attachment in the dyad. Objectives. This investigation seeks to analyze relational risks, attachment styles, and to compare the prevalence of depressive symptoms between teenage mothers and adult mothers during pregnancy and postpartum. Methods. An observational prospective cohort study was carried out, considering primiparous mothers, both teenage and adults, who attended primary public healthcare centers in Valparaíso during 2013. Results: In comparison to adult mothers, teenage mothers were more likely to exhibit insecure attachment styles, depressive symptoms in pregnancy and postpartum, and scored higher in the relational risk assessment scale. However, only the difference on the rate of insecure attachment styles between teenage and adult mothers was statistically significant.

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OBJECTIVE: The objective of this study was to evaluate the association between (1) different types of ACEs and migraine, and (2) the number of ACEs and migraine among adolescent mothers in Lima, Peru. METHODS: Our cross-sectional study included 787 adolescent mothers (14- to 18-years of age) in Peru. In-person interviews were conducted postpartum, in hospital, within 2-days of delivery. Nine types of ACEs were assessed, including exposure to three categories of abuse, two categories of neglect, and four categories of household dysfunction. Multivariable logistic regression procedures were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CI) for the association between ACEs and migraine while adjusting for putative confounders. RESULTS: Approximately 75% of adolescent mothers reported having experienced at least one type of ACE. Adolescent mothers who reported any childhood abuse had 1.49-fold increased odds of migraine (aOR = 1.49; 95% CI 1.03-2.18) compared to those with no history of childhood abuse. Adolescent mothers who reported experiencing household dysfunction had 1.56-fold increase odds of migraine (aOR = 1.56; 95% CI 1.09-2.24). Compared to participants who reported no ACE, those who experienced four or more ACEs had 3.09-fold (aOR = 3.09; 95% CI 1.80-5.40) increased odds of migraine (ptrend < 0.001). CONCLUSION: Exposure to ACEs is highly prevalent in adolescent-aged mothers postpartum and is associated with increased odds of migraine. These findings support the importance of screening for ACEs and migraine among adolescent mothers; and the need for providing culturally appropriate, trauma-informed headache care.

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BACKGROUND: Calcium plus vitamin D supplementation of pregnant Brazilian adolescents with habitually low calcium intake (∼600 mg/d) reduced bone loss during the first 20 wk postpartum. OBJECTIVE: We investigated maternal bone mass changes during the first year postpartum as a follow-up of the clinical trial. METHODS: Pregnant adolescents (14-19 y) received calcium (600 mg/d) plus cholecalciferol (200 IU/d) supplementation (n = 30) or placebo (n = 26) from 26 wk of gestation until parturition. Bone area and bone mineral content and bone mineral density (BMD) at total body, lumbar spine, and hip (total and femoral neck) were assessed by DXA at 3 time points postpartum (5 wk, 20 wk, and 56 wk). Intervention group, time postpartum, and group × time interaction effects were tested by repeated-measures mixed-effects models adjusting for calcium intake, return of menses, breastfeeding practices, and body weight. RESULTS: Time (P < 0.05) but not group affected several absolute bone measurements. There was a group × time interaction for femoral neck BMD (P = 0.045). Mean ± SE values (g/cm2) at 5 wk, 20 wk, and 56 wk were, respectively, 1.025 ± 0.026, 0.980 ± 0.026, and 1.022 ± 0.027 for the placebo group and 1.057 ± 0.025, 1.030 ± 0.024, and 1.055 ± 0.025 for the supplemented group. An interaction also was observed for percentage change in femoral neck BMD relative to 5 wk (P = 0.049), with a more pronounced decrease in the placebo group (-4.58 ± 0.42%) than in the supplemented group (-3.15% ± 0.42%) at 20 wk (P = 0.019), and no difference between groups at 56 wk (-0.44% ± 0.71% in the placebo and -0.76% ± 0.62% in the supplemented group; P = 0.65). CONCLUSIONS: Calcium plus vitamin D supplementation of the adolescent mothers reduces the magnitude of bone loss at the femoral neck from 5 to 20 wk postpartum without an effect on bone changes after 1 y postpartum, indicating that there is no sustained effect of the supplement tested.

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Abstract Introduction The birth experience of adolescents is understudied even though they are a particularly vulnerable population to experience a negative birth event, given that they exhibit many known risk factors. Objective To ascertain whether a cesarean birth mediates the impact of infant complications on the birth experience of adolescent mothers. Methods Using a secondary analysis of data collected from 303 postpartum adolescents previously evaluated for depression and post-traumatic stress, we employed counterfactual causal analysis to determine if delivery type mediated the birth experience at different levels of depression. Noted limitations pertain to methodological assumptions and computational feasibility as well as potential sample bias. Results We found that the mediating effect of delivery mode depended on the adolescent's depression level as well as on the specific operationalization of the birth experience. At low levels of depression, the odds of a negative birth appraisal were reduced by around 30% when operationalized as a single item subjective rating. In contrast, at high levels of depression, the odds of a negative birth experience increased by 80% when operationalized as an Impact of Event Scale (IES) subconstruct. Conclusion Depression level plays a pivotal role in moderating how delivery mode mediates the birth experience. The direction of impact also depends on how the birth experience is operationalized.

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A large number of children of depressed mothers have one or more mental disorders. This study aimed to evaluate the impact of maternal depression on the mental health of 4-5-year-old children of adolescent mothers, according to the hypotheses generated from the model of accumulation. Between October 2009 and March 2011, all pregnant adolescents who received prenatal care from the public health system in Pelotas (southern Brazil) were invited to participate in the study and have been prospectively followed. Of these individuals, 413 participants were evaluated in the postpartum period and when the child was 2-3 years old and 4-5 years old (current stage). The Strengths and Difficulties Questionnaire was used to assess mental health problems in children, and the Mini International Neuropsychiatric Interview (MINI)-Plus version was used to assess maternal depression. We applied a structured modeling approach to examine the relations between three different hypothesized life course models (accumulation, critical period, and mobility) and maternal depression. After selecting the most appropriate model, we used a logistic regression analysis to assess the effect of depression on mental health problems in 4-5-year-old children of adolescent mothers. We used the Chi square test to estimate the prevalence of mental health problems in 4-5-year-old children. The longer the time of exposure to maternal depression, the greater the probability that the child would present behavioral problems. Investments in strategies to prevent mental disorders beginning in the gestational period are important.

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RESUMEN A pesar del desarrollo del programa materno infantil en Cuba existe un gran número de adolescentes que se embarazan, a lo que se adiciona la gran atención que se brinda al programa materno infantil, por lo que muchos médicos limitan a la embarazada al reposo, sobre todo si se trata de una adolescente y esto trae como consecuencia que generalmente se enfrentan al parto sin un entrenamiento previo. Por la importancia de este tema en materia de salud materno infantil, se realizó este trabajo con el propósito de hacer reflexionar a todos los integrantes del programa y aumentar el nivel de conocimientos de los profesionales sobre las ventajas de la psicoprofilaxis obstétrica en las gestantes adolescentes, así como fomentar un trabajo en equipo para de esta manera conseguir el máximo beneficio de las madres adolescentes, los bebés y sus familias. Una gestante adolescente preparada es una gestante colaboradora con un parto en las mejores condiciones físicas y psíquicas, para así lograr así un hijo sano, fuerte y la felicidad más grande de su vida (AU).

SUMMARY Despite the development of the maternal and child program in Cuba, there are a large number of teenagers who become pregnant to which is added the great attention that is given to the maternal and child program, so many doctors limit the pregnant woman to rest, especially if It is a teenage girl and this brings as a consequence that they generally face childbirth without prior training. Due to the importance of this topic in maternal and child health, this work was carried out with the purpose of making all the members of the program reflect and increase the level of knowledge of professionals about the advantages of obstetric psychoprophylaxis in pregnant adolescents, as well as encouraging teamwork to obtain the maximum benefit from teenage mothers, babies and their families. A pregnant pregnant woman is a pregnant collaborator with a birth in the best physical and psychic conditions, thus achieving a healthy, strong child and the greatest happiness of her life (AU).

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Introducción: La depresión posparto es un trastorno depresivo que puede empezar en cualquier momento después del parto que puede durar de semanas a meses, se acompaña de síntomas como: fatiga, pérdida de energía, incomodidad, problemas para conciliar el sueño, entre otros. Objetivo: Diseñar una estrategia que contribuya a la prevención de la depresión posparto en madres adolescentes atendidas en el servicio de Gineco-obstetricia del Hospital General Ambato. Métodos: La investigación responde a una modalidad cuantitativa; no experimental con desarrollo de diagnóstico transversal, descriptivo con una muestra de 50 madres adolescentes. Resultados: Las madres adolescentes más propensas a sufrir una depresión posparto están comprendidas entre los 14-16 años en un 58% y son solteras en un 72%, la relación que mantienen con la familia es buena en un 38%, la violencia física y psicológica intrafamiliar si existe rara vez demostrándose en un 48%, existe un desconocimiento sobre la depresión posparto manifestándose en un 98%. Conclusiones: Los factores predisponentes para desencadenar en una depresión posparto son las madres adolescentes solteras por la falta de apoyo de la pareja, la relación afectiva y de dependencia que tienen con la familia, la falta de apoyo proporcionado por la familia durante el embarazo y en la crianza del bebé y lo más relevante el desconocimiento sobre la depresión posparto por ende no estarían en capacidad de reconocer la sintomatología

Introduction: Postpartum depression is a depressive disorder that can start at any time after delivery that can last from weeks to months, is accompanied by symptoms such as fatigue, loss of energy, discomfort, trouble falling asleep, among others. Objective: To design a strategy that contributes to the prevention of postpartum depression in adolescent mothers assisted in the Obstetrics and Gynecology service of the Ambato General Hospital. Methods: The research responds to a quantitative modality; non-experimental with development of cross-sectional diagnosis, descriptive with a sample of 50 adolescent mothers. Results: Adolescent mothers more prone to suffer postpartum depression are between 14-16 years old in 58% and are single in 72%, their relationship with the family is good in 38%, physical violence and intrafamilial psychological if it is rarely demonstrated by 48%, there is a lack of knowledge about postpartum depression manifested in 98%. Conclusions: The predisposing factors to trigger postpartum depression are single teenage mothers due to the lack of support from the couple, the affective and dependent relationship they have with the family, the lack of support provided by the family during pregnancy and in the upbringing of the baby and most relevant the ignorance about the postpartum depression therefore they would not be able to recognize the symptomatology

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Objetivo: describir el riesgo familiar total y grado de salud familiar en un grupo de familias de madres adolescentes con hijos en lactancia materna, que participan en el servicio de Creciendo en Familia en la localidad de Usme, Bogotá D.C. Metodología: estudio cuantitativo de tipo descriptivo, el enfoque teórico fue la Teoría de Riesgo Familiar Total y sus postulados de la doctora Pilar Amaya, mediante la aplicación de los instrumentos: RFT 5-33 y ISF-GEN 21, a una muestra conformada por 70 familias de madres adolescentes menores de 19 años que practican la lactancia materna, vinculadas al servicio Creciendo en Familia de la Secretaria Distrital de Integración Social, en la localidad de Usme. Se realizó entre los meses de octubre y noviembre del 2018, de igual manera, cabe aclarar que aceptaron participar voluntariamente. Resultados: el estudio estuvo conformado por 385 integrantes de las 70 familias participantes, predomino la tipología familiar extensa modificada 63%, en el 10% de las familias había presencia de una gestante, un 66% de las familias nunca ha recibió información en educación sexual y el 82% de las familias se percibieron como sanas, a pesar de referir factores de riesgo en su salud actual. El estudio demostró que todas las familias con madres adolescentes con hijos en lactancia están en riesgo, distribuido así: 63% están amenazadas, 27% están en alto riesgo y el 10% están en riesgo bajo, asociado a condiciones de vulnerabilidad social y familiar. Sin embargo, en relación con el grado de salud, el 53% de las familias se perciben como saludables, 41% de las familias como muy saludables y solo el 6% se perciben como poco saludables, expresado en la satisfacción 49% y organización 61% respecto al funcionamiento familiar de la misma. Conclusiones: las familias conformadas por madres adolescentes con hijos en lactancia materna en el contexto estudiado, presentan características familiares, individuales y sociales asociadas a su condición de vulnerabilidad y con diferentes niveles de riesgo para su salud. Sin embargo, las familias se perciben como saludables (94%), manifestado en el apoyo integral que recibe la madre adolescente desde la gestación, parto y proceso de crianza, incluida la etapa de lactancia materna, expresado por las familias como sentimientos de satisfacción independiente a los factores de riesgo a los que están expuestos, de esta manera, la diferencia entre el abordaje de riesgo familiar total y el grado de salud familiar corresponde a la dinámica interna de la familia durante su etapa de lactancia materna.

Objective: Describe the total family risk and degree of family health in a group of families of adolescent mothers with children in breastfeeding, who participate in the Growing in Family service in the town of Usme, Bogotá D.C. Methodology: quantitative study of a descriptive type, the theoretical approach was the Total Family Risk Theory and its postulates of Dr. Pilar Amaya, through the application of the instruments: RFT 5-33 and ISF-GEN 21, to a sample formed by 70 families of adolescent mothers under 19 who practice breastfeeding, linked to the Growing in Family service of the District Secretary of Social Integration, in the town of Usme. It was carried out between the months of October and November 2018, in the same way, it is clear that they accepted to participate voluntarily. Results: the study consisted of 385 members of the 70 participating families, 63% of which were extended family typologies, 10% of the families had a pregnant woman, 66% of the families had never received information on sex education and 82% of the families were perceived as healthy, despite referring risk factors in their current health. The study showed that all families with teenage mothers with breastfeeding children are at risk, distributed as follows: 63% are threatened, 27% are at high risk and 10% are at low risk, associated with social and family vulnerability conditions. However, in relation to the degree of health, 53% of families perceive themselves as healthy, 41% of families as very healthy and only 6% perceive themselves as unhealthy, expressed in satisfaction 49% and organization 61 % regarding the family operation of the same. Conclusions: families formed by adolescent mothers with children in breastfeeding in the context studied, have family, individual and social characteristics associated with their vulnerability and with different levels of risk to their health. However, families perceive themselves as healthy (94%), manifested in the comprehensive support that the adolescent mother receives from pregnancy, childbirth and the parenting process, including the stage of breastfeeding, expressed by families as feelings of independent satisfaction to the risk factors to which they are exposed, in this way, the difference between the approach of total family risk and the degree of family health corresponds to the internal dynamics of the family during its stage of breastfeeding.

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This manuscript aims to present and discuss challenges regarding naturalistic observation of adolescent mothers and their infants throughout the first postpartum year. Case illustrations were the object to discuss methodological options and issues faced during an observational and longitudinal research. The participants live in vulnerability in a metropolitan area in Southern Brazil. Data collection challenges led to reflections about naturalistic observation and methodological procedures, which were affected by setting characteristics and by the need of adapting to them. Most methodological difficulties were linked to naturalistic observations of mothers and their infants. Personal and contextual aspects of these settings must be taken into account in order to enhance result reliability and the knowledge about cultural idiosyncrasies.

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