Association Between Self-Esteem and Family Functioning with Adolescent Pregnancy. A Case-Control Study.

Abstract

Adolescent pregnancy is a global phenomenon that increases the risk of maternal and neonatal morbidity and mortality. In addition, early parenthood has implications that foster intergenerational poverty and social exclusion. Hence, this study aimed to evaluate the association between self-esteem and family functioning with teenage pregnancy. We conducted a case-control study from April to November 2023 at two community health centers in Hidalgo, Mexico. Primiparous adolescents aged 10 to 19 whose gestational age was less than 21 weeks and who attended a prenatal checkup consultation were considered the case group. Conversely, the control group consisted of non-pregnant adolescents (aged 10-19 years) who visited the same community health centers for medical consultations. The APGAR family scale was used to assess the family functioning of the participants, and self-esteem was assessed using the Rosenberg Self-Esteem Scale. The associations between the variables of interest were evaluated using logistic regression models adjusted by confounders. After adjusting for confounders, adolescents with medium (adjusted odds ratio [aOR] = 1.81; 95% confidence interval [95% CI] = 0.91, 3.59; p-value = .086) and lo8w self-esteem (aOR = 4.04; 95% CI = 1.96, 8.31; p-value = .030) compared to those with high self-esteem were more likely to be mothers. Besides, we found that the lower the self-esteem, the greater the odds of being an adolescent mother (p-trend <0.014). On the other hand, adolescents with moderate (aOR = 2.31; 95% CI = 1.03, 5.21; p-value = .031) and severe family dysfunction (aOR = 4.00; 95% CI = 1.61, 9.97; p-value = .001) were more likely to be adolescent mothers compared to those with good family functioning. Furthermore, we found that the greater the family dysfunction degree, the higher the risk of being an adolescent mother (p-trend <0.001). Our findings suggest that self-esteem and family functioning are independently associated with adolescent pregnancy. This adds to the existing literature that emphasizes the relevance of promoting emotional well-being and family relationships to prevent risky behaviors among adolescents. Therefore, it is necessary to develop holistic intervention programs that promote healthy family relationships and consider strengthening sexual assertiveness and self-esteem from early adolescence.