title: Estimating Post-Emergency Fertility Among Disaster-Affected Adolescents: Findings From a Case-Control Study in Aceh Province, Indonesia.
abstract: OBJECTIVE
  We aimed to retrospectively estimate adolescent fertility rates before and after a large-scale natural disaster.
  
  
  METHODS
  A case-control study was conducted in Aceh Province, Indonesia, 2 years after the Indian Ocean tsunami in 2004. The age-specific fertility rates of 15-19-year-old-women (ASFR 15-19) was estimated each year from 2004 to 2006 by creating hypothetical age cohorts. The results were compared with data from the closest edition of the Indonesian Demographic Health Survey (IDHS).
  
  
  RESULTS
  The pre-disaster ASFR 15-19 (4.4% in 2004) was not significantly different from the 2002-2003 IDHS data (P=0.49), whereas the post-disaster ASFR 15-19 (1.1% in 2005-2006) was significantly lower than the provincial estimation in the 2007 IDHS (P<0.01). ASFR 15-19 was reduced by 76% in the post-disaster period compared with the pre-disaster period (rate ratio: 0.24, P=0.02).
  
  
  CONCLUSIONS
  The creation of hypothetical age cohorts enabled valid and useful estimation of the ASFR in disaster-affected areas where reliable vital statistics are not available. For pre-disaster fertility estimation, however, we suggest excluding data from the 40-week period preceding the disaster, because the data may be biased by excess mortality in childbearing mothers and newborn babies in the disaster.
authors.affiliation: 1AIDS Clinical Center,National Center for Global Health and Medicine,Tokyo,Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Kinoshita
authors.affiliation: 2Ujong Fatihah Hospital,Nagan Raya District,Aceh Province,Indonesia.
authors.forename: Suhardan
authors.initials: S
authors.lastname: Suhardan
authors.affiliation: 3Regional Family Planning and Population Board of Ogan Ilir Regency,Indralaya,South Sumatera,Indonesia.
authors.forename: Damsyik
authors.initials: D
authors.lastname: Danila Danila
authors.affiliation: 4Nagoya University Graduate School of Medicine,Department of Public Health and Health Systems,Nagoya,Japan.
authors.forename: Chifa
authors.initials: C
authors.lastname: Chiang
authors.affiliation: 4Nagoya University Graduate School of Medicine,Department of Public Health and Health Systems,Nagoya,Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Aoyama
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004190:Disasters; D005260:Female; D005298:Fertility; D006801:Humans; D007214:Indonesia; D012189:Retrospective Studies; D017741:Survivors / Q000706:statistics & numerical data*; D057192:Tsunamis / Q000706:statistics & numerical data; D055815:Young Adult
keywords: adolescent fertility; pre/post-disaster; survivor effect