International journal of environmental research and public health · 2026
Structural and Intermediate Social Determinants of Health Linked to Adolescent Pregnancy in the Peruvian Rural Context.
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Sánchez Gómez Suli, Silva-Diaz Yshoner Antonio, Vega-Rojas Ruth Clarivel, Odar-Rojas Cintya Elisabeth, Rodriguez Medina José Luis, Muñoz Zumaeta Miuller Raul, Vela Zuta Hitler Adolfo
Аннотация
BACKGROUND: Adolescent pregnancy is a public health problem in Latin America, with a higher prevalence in rural areas. This population faces barriers to accessing education and healthcare services, increasing the risk of maternal and neonatal complications.
METHODS: This study employed a cross-sectional analytical design and included 72 adolescents aged 12 to 17 years in Lonya Grande. The associations between structural and intermediate social determinants of health and the prevalence of adolescent pregnancy were assessed.
RESULTS: Among the structural determinants, extreme poverty (PR: 2.48; 95% CI: 1.23-5.03; p = 0.004), type of public health insurance (PR: 3.05; 95% CI: 1.21-7.72; p = 0.005), and parental educational level were associated with a higher prevalence of adolescent pregnancy. After adjustment, having public health insurance (aPR: 0.49; 95% CI: 0.36-0.66; p < 0.001) and having parents who had completed primary school (aPR: 1.67; 95% CI: 1.15-2.42; p = 0.01) were associated with a higher prevalence of adolescent pregnancy. Among the intermediate determinants, alcohol consumption (PR: 2.77; 95% CI: 1.85-4.16; p < 0.001), knowledge about contraceptives (PR: 0.21; 95% CI: 0.03-0.85; p = 0.04), and being 17 years old (PR: 4.44; 95% CI: 1.48-13.39; p = 0.01) were associated with adolescent pregnancy. In the adjusted model, adolescents aged 15 years (aPR: 3.15; 95% CI: 1.04-9.52; p = 0.04) maintained a higher prevalence compared with those aged 14 years.
CONCLUSIONS: An association was found between structural and intermediate social determinants of health and adolescent pregnancy in rural settings. These findings suggest the need for additional studies to better understand interventions targeting these associated factors.
METHODS: This study employed a cross-sectional analytical design and included 72 adolescents aged 12 to 17 years in Lonya Grande. The associations between structural and intermediate social determinants of health and the prevalence of adolescent pregnancy were assessed.
RESULTS: Among the structural determinants, extreme poverty (PR: 2.48; 95% CI: 1.23-5.03; p = 0.004), type of public health insurance (PR: 3.05; 95% CI: 1.21-7.72; p = 0.005), and parental educational level were associated with a higher prevalence of adolescent pregnancy. After adjustment, having public health insurance (aPR: 0.49; 95% CI: 0.36-0.66; p < 0.001) and having parents who had completed primary school (aPR: 1.67; 95% CI: 1.15-2.42; p = 0.01) were associated with a higher prevalence of adolescent pregnancy. Among the intermediate determinants, alcohol consumption (PR: 2.77; 95% CI: 1.85-4.16; p < 0.001), knowledge about contraceptives (PR: 0.21; 95% CI: 0.03-0.85; p = 0.04), and being 17 years old (PR: 4.44; 95% CI: 1.48-13.39; p = 0.01) were associated with adolescent pregnancy. In the adjusted model, adolescents aged 15 years (aPR: 3.15; 95% CI: 1.04-9.52; p = 0.04) maintained a higher prevalence compared with those aged 14 years.
CONCLUSIONS: An association was found between structural and intermediate social determinants of health and adolescent pregnancy in rural settings. These findings suggest the need for additional studies to better understand interventions targeting these associated factors.