Fertility rates among very young adolescent women: temporal and spatial trends in Brazil

• Grant number: 16/03933-6
• Support Opportunities: Regular Research Grants - Publications - Scientific article
• Start date: July 01, 2016
• End date: December 31, 2016
• Field of knowledge: Health Sciences - Collective Health
• Principal Investigator: Ana Luiza Vilela Borges
• Grantee: Ana Luiza Vilela Borges
• Host Institution: Escola de Enfermagem (EE). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Background: Adolescent fertility rate has recently declined in Brazil, with marked regional differences. However, childbirths among very young adolescents aged 10 to 14 years occur at much lower rates. In face of drastic consequences when very young adolescents become pregnant and the lack of data, we aimed to explore temporal trends for fertility rates among very young adolescents (10 to 14 years old) between 2000 and 2012 for Brazil as a whole, its regions and states; and to analyze the spatial distribution of fertility rates among Brazilian municipalities in the years 2000 and 2012. Methods: We used data from the Information System on Live Births to calculate the rates. To examine the temporal trends, we used linear regression for time series with Prais-Winsten estimation, including the annual percentage change, for the country, regions, and states. To analyze the spatial distribution among Brazilian municipalities, we calculated the Global Moran Index and created a local Moran significance and cluster map through Local Indicators of Spatial Association (LISA). We also elaborated a thematic map with the rates using empirical Bayesian estimation. Results: Brazilian very young adolescent fertility rates remained high and stable throughout the 2000 to 2012 period, and significantly decreased in three out of 26 states, and in the federal district. On the other hand, an increase was observed in two Northern and Northeastern states. The rates were spatially dependent in Brazilian municipalities (Moran Index=0.22 in 2012; p=0.05). The maps indicated a heterogeneous distribution of the rates, with high-rate clusters predominant in the North and low-rate clusters predominant in the South, Southeast, and Midwest. Conclusions: Our findings indicate that overall Brazilian very young adolescent fertility rates remain high and did not decrease from 2000 and 2012, even though a few states presented a decrease. Considering the very young adolescent pregnancy relation to poverty, violence and poor school connection, we suggest development of specific policies and programs focused on this age group. (AU)