title: Risk factors for pregnancy among adolescent girls in Ecuador's Amazon basin: a case-control study.
abstract: OBJECTIVE
  To examine risk factors for pregnancy among adolescent girls in the Amazon basin of Ecuador.
  
  
  METHODS
  A matched case-control study with cases and controls identified within a community-based demographic and health survey was conducted in Orellana, Ecuador, from May to November 2006. A questionnaire focused on socioeconomic status, family structure, education, reproductive health, and childhood-adolescent trauma was applied. Conditional logistic regression was used to adjust for potential confounders.
  
  
  RESULTS
  Respondents included 140 cases and 262 controls. Factors associated with increased risk of adolescent pregnancies through multivariate analysis were: sexual abuse during childhood-adolescence (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.08-8.68); early sexual debut (OR 8.51, 95% CI 1.12-64.90); experiencing periods without mother and father (OR 10.67, 95% CI 2.67-42.63); and living in a very poor household (OR 15.23, 95% CI 1.43-162.45). Another two factors were statistically associated in the bivariate analysis: being married or in a consensual union (OR 44.34, 95% CI 17.85-142.16) and not being enrolled in school at the time of the interview (OR 6.31, 95% CI 3.70-11.27). For a subsample of sexually initiated adolescents, "non-use of contraception during first sexual intercourse" was also found to be a risk factor (OR 4.30, 95% CI 1.33-13.90).
  
  
  CONCLUSIONS
  The study found that early sexual debut, non-use of contraception during first sexual intercourse, living in a very poor household, having suffered from sexual abuse during childhood-adolescence, and family disruption (living extended periods of life without both parents) were associated with adolescent pregnancy in Orellana.
authors.affiliation: Department of Public Health and Clinical Medicine, Epidemiology and Public Health, Umeå University, Umeå, Sweden. isabel.goicolea@obgyn.umu.se
authors.forename: Isabel
authors.initials: I
authors.lastname: Goicolea
authors.forename: Marianne
authors.initials: M
authors.lastname: Wulff
authors.forename: Ann
authors.initials: A
authors.lastname: Ohman
authors.forename: Miguel
authors.initials: M
authors.lastname: San Sebastian
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D004484:Ecuador; D005260:Female; D006801:Humans; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D012307:Risk Factors