Fatores da desigualdade social e a sua associação com a gravidez na adolescência: uma revisão integrativa
Palavras-chave:
Adolescente, Epidemiologia, Fatores socioeconômicos, Gravidez na Adolescência, Pobreza
Resumo
Objetiva-se identificar quais fatores da desigualdade social estão associados à gravidez na adolescência. Como método, utilizou-se a revisão integrativa da literatura e a busca dos artigos foi realizada entre junho/2021 e abril/2022 nos bancos de dados Pubmed via Medline, Scopus e Embase. A amostra final totalizou 28 artigos e verificou-se que os fatores de proteção associados à gravidez na adolescência foram a renda familiar mais elevada e a maior escolaridade do adolescente e dos pais. Como fatores de risco, destacaram-se o consumo de álcool, tabaco e outras drogas, a atividade sexual precoce e o perfil socioeconômico e demográfico. Investimentos em setores como o da educação contribuiriam para a redução das taxas de gravidez precoce porque a escola estimula a criação de projetos de vida e incentiva comportamentos mais adequados. O conhecimento acerca dos fatores da desigualdade social que aumentam o risco da gravidez precoce podem auxiliar a formulação de políticas públicas que diminuam as desigualdades em saúde.
Referências
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4.Alves JSA, Gama SGN; Viana MCM, Guidolini MK, Santos Neto ET. Características socioeconômicas influenciam as atitudes face à sexualidade em adolescentes, J Hum Growth Dev.2021; 31(1):101-115. doi: https://doi.org/10.36311/jhgd.v31.11084
5.Wado YD, Sully EA, Numah JN. Pregnancy and early motherhood among adolescents in five East African countries: a multi-level analysis of risk and protective factors. BMC Pregnancy Childbirth.2019; 19:59. doi: https://doi.org/10.1186/s12884-019-2204-2
6.Habito CM, Vaughan C, Morgan A. Adolescent sexual initiation and pregnancy: what more can be learned through further analysis of the demographic and health surveys in the Philippines? BMC Public Health.2019; 19(1142). doi: https://doi.org/10.1186/s12889-019-7451-4
7. Agbor VN, Mbanga CM, Njim J. Adolscent deliveries in rural Cameroon: an 8-year trend, prevalence and adverse moternofetal outcomes. Reprod Health. 2017; 14(1):122. doi: https://doi.org/10.1186/s12978-017-0382-6.
8.Brasil. Ministério da Saúde. Secretaria de Atenção em Saúde. Departamento de Ações Programáticas Estratégicas. Prevenção de gravidez na adolescência é tema de campanha nacional. Brasília: Ministério da Saúde, 2020. [Acesso em 03 maio 2022]. Disponível em: https://bvsms.saude.gov.br/01-a-08-02-semana-nacional-de-prevencao-da-gravidez-na-adolescencia/
9.Brasil. Estatuto da Criança e do Adolescente. Sanção do Artigo 8o /2019. [Acesso em 03 maio 2022]. Disponível em: https://www.gov.br/mdh/pt-br/centrais-de-conteudo/crianca-e-adolescente/estatuto-da-crianca-e-do-adolescente-versao-2019.pdf
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11.Gausman H, Langer A, Austin SB, Subramanian SU. Contextual variation in Early Adolescent Childbearing: A Multilevel Study From 33,822 Communities in 44 Low and Middle- Income countries. J Adolesc Health. 2019; 64:737-745. doi: https://doi.org/10.1016/j.jadohealth.2018.11.018
12.Kefale B, Yalew M, Damte Y, DamteY, Adane B. A Multilevel Analysis of Factors Associated with Teenage Pregnancy in Ethiopia. Intern. J Women´s Health.2020; 12:785-793. doi: https://doi.org/10.2147/IJWH.S265201
13.Moher D; Liberati A; Tetzalaff J; Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi: https://doi.org/10.1016/j.ijsu.2010.02.007
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15.Ochen AM, Chi PC, Lawoko S. Predictors of teenage pregnancy among girls aged 13-19 years in Uganda: acommunity based case-control study. BMC Pregnancy Childbirth.2019; 19(1):211. doi: https://doi.org/10.1186/s12884-019-2347-Y
16.Muchunu G, Peltzer K, Tutshana B, Surtlwadi L. Adolescent pregnancy and associated factors in South African youth. African Health Sciences.2012; 12(4):426-434. doi: https://doi.org/10.4314/ahs.V12i4.5
17.Amoo EO, Igbinoba A, Imbonopi D, Solanke LB. Trends, Determinants and health risks of adolescent fatherhood in Sub-Saharan África. Ethiop J Health Sci. 2018; 28(4):433.doi:https://doi.org/10.4314/ejhs.v28i4.9
18.Garfield CF, Duncan G, Peters S, Rutsohn J, McDade JW, Adams EK et al. Adolescent Reproductive Knowledge, attitude, and beliefs and future fatherhood. J Adolesc Health.2016; 58(5):497-503.doi: https://doi.org/10.1016/j.jadohealth.2015.12.010
19.Exavery A, Kanti AM, Meema S, Philips JF, Masanja H. Multilevel analysis of childbirth in childhood in Tanzânia in Ruffiti District. Matern Child Health J.2016; 20(2): 447-455. doi: https://doi.org/10.1007/s10995-015-1842-7
20.Panova OV, Kulikov AM,Berchtold A, Suris JC. Factors associated with unwanted pregnancy among adolescents in Russia. J Pediatr Adolesc Gynecol.2016; 29(5):501-505. doi: https://10.1016/j.jpag.2016.04.004
21.Izugbara C. Socio-demographic risk factors for unintended pregnancy among unmarried adolescent Nigerian girls. S Afr Fam Pract.2015; 57(2):121-125. doi: https://doi.org/10.1080/20786190.2014.977042
22.Espinel-Flores V, Gotsens M, Pierg-Barrachina V, Gómez BBL, Perata A, Pérez F. Trend in teenage in Ecuador: challenges and inequalities. Int. J Public Health.2020; 65(9):1647-55. doi: https://doi.org/10.1007/s00038-020-01517-w
23.Okigbo CC, Speizer HS. Determinants of Sexual activity and Pregnancy among Unmarried Young women in Urban Kenya: Across-sectional study. PLosONE.2015; 10(6)e0129286. doi: https://doi.org/10.1371/journal.pone.0129286
24.Maness SB, Buhi ER, Daley EM, Baldwin JA, Kramrey JD. Social Determinants of Health and Adolescent Pregnancy: An Analysis from the National Longitudinal Study of Adolescent.2016; 58:636-643. doi: https://doi.org/10.1016/j.jadohealth.2016.02.006
25.Uwizeye D, Muhayitito R, Kantarama E, Wilheler S, Murangwa Y. Prevalence of teenage pregnancy and the associated contextual correlates in Rwanda. Heliyon. 2020; 6:e05037. doi: https://doi.org/10.1016/j.heliyon.2020.e05037
26. Acosta-Varela M, Cárdenas-Ayala VM. EL embarazo en adolescentes factors sócio culturales. Rev. Med. Inst. Mex. Seguro Soc. 2012; 50(4):371-374. Disponível em: https://www.redalyc.org/articulo.oa?id=457745496006
27. Ayele BG/Kidan, Gebregziabher TG, Hailu TT, Assefa BA. Determinants of teenage pregnancy in Degrea Timbien District, Tigray, Northern Ethiopia: A community based case-control study. PLoS One.2018; 13(7):e0200898. doi: https://doi.org/10.1371/journal.pone.0200898
28.Mezmur H, Assefa N, Alemayehu T. Teenage Pregnancy and its Associated Factors in Eastern Ethiopia: A Community-Based Study. Int. J Women´s Health. 2021; (13):267-278.doi: https://doi.org/10.2147/IJWH.S287715
29. Habitu YA, Yalew A, Bisetegen TA. Prevalence and Factors Associated with Teenage Pregnancy, Northeast Ethiopia 2017: A Cross-Sectional Study. J Pregnancy (Online).2018. doi: https://doi.org/10.1155/2018/1714527
30.Christofides NJ, Jeweks RK, Dunker KL, Mccarty F, Shai NJ, Nauma M, et al. Risk factors for unplanned and unwanted teenage pregnancies occurring over two years of follow up among a cohort of young South African women. Glob. Health Action.2014; 7:23719. doi: https://doi.org/10.3402/gha.v7.23719
31.Jonas K, Crutzen R, Borne B, Sewpaul R, RiddyP.Teenage pregnancy rates and association with other health risk behaviors: a three-wave cross sectional studyamong.South African school going adolescents. Reprod Health.2016; 13(1):50.doi: https://doi.org/10.1186/s12978-016-0170-8
32.Brahmbhaltt H, Kagesten A, Emerson M, Decker M, Olumed A, Ojingbede O, et al. Prevalence and determinants of adolescent pregnancy in urban, disadvantaged settings across cities. J Adolesc Health.2014; 55(60):548-557. doi: https://doi.org/10.1016/j.jadohealth.2014.07.023
33.Vásquez-Nava F, Vásquez-Rodriguez CF, Saldívar-González AH, Vásquez-Rodriguez EM, Córdova-Fernández JA, Felizardo AJ, Sánchez-Márquez W. Unplanned Pregnancy in Adolescence: Association with Family Structure, Employed Mother, and Female Friends with health risks habits and behaviors. J Urban Health.2013; 9(1):176-185. doi: https://doi.org/10.1007/s11524-013-9819-6
34. Móron-Duarte SL, Latorre C, Tavar JR. Risk factors for adolescent pregnancy in Bogotá, Colombia, 2010: a case control study. Rev. PanamSalud. Publica. .2014; 36(3):179-84. Disponível em: https://www.scielosp.org/article/rpsp/2014v36n3/179-184/
35.Bekalau Gk, Habitamu GB, Alemu DB. Teenage pregnancy and its associated factors among teenage females in frartaworeda, Northwest, Ethiopia. 2020: A community based cross-sectional study. Popul. Med.2021; 3:19. doi: https://doi.org/10.18332/popmed/139190
36. Zamora MHRN. Desigualdade racial, racismo e seus efeitos. Fractal, Ver. Psicol. 2012; 24(3)doi: https://doi.org/10.1590/S1984-02922012000300009
37. Moura FS, Júnior JAS, Rolim ACA, Silva KL, Jacob LMS. Determinantes sociais da saúde associados à gravidez na adolescência. R. Saúde Públ. Paraná. 2021; 4(1):133-150. doi: https://doi.org/10.32811/25954482-2021v4n1p133
38.Aguia-Rojas K, Ardila ADG, Bonella MVE, Rodriguéz-Niño JN. Individual and Contextual factors associated with teenage pregnancy in Colombia: A multilevel analysis. Matern Child Health J.2020; 24(11):1376-86. doi: https://doi.org/10.1007/s10995-020-02997-1
39.Islam MM, Islam MK, Hasan MS, Hossan MB. Adolescent motherhood in Bangladesh: Trend and determinants. PLosONE.2017; 12(11)e0188294. doi: https://doi.org/10.1371/journal.pome.0188294
40.Rodríguez-Vignoli J, Cavenaghi S. Adolescent and youth fertility and social inequality in Latin America and the Caribbean: what role has education played? GENUS.2015; 70(1):1-25. Disponível em: https://www.jstor.org/stable/genus.70.1.1
41.Nunes TGR, Pontes FAR, Silva LIC, Dell'aglio DD. Fatores de risco e proteção na escola: Reprovação e expectativa de futuro de jovens paraenses. Revista Quadrimestral da Associação Brasileira de Psicologia Escolar e Educacional.2014; 18(2):203-210. doi: https://doi.org/10.1590/2175-3539/2014/0182732
42. Shackleton N, Jamal F, Viner R, Dickson K, Hinds K, PATTON G, BONELL C. Systematic Review of reviews of observational studies of school level effects on sexual health, violence and substance use. Health&Place.2016; 39: 168-176. doi: https://doi.org/10.1016/j.healthplace.2016.04.002
43. Dudovitz RN, Chung PJ, Nelson B, Wong MD. What to be when you grow up? Career aspiration as marker for adolescent wellbeing. Acad Pediatr.2017; 17(2):153-160. doi: https://doi.org/10.1016/j.acap.2016.08.006
44. Zappe JG, Alves CF, Dell’aglio DD. Comportamentos de risco na adolescência: Revisão sistemática de estudos empíricos. Psicol. Rev. 2018; 24(1):79-100. Disponível em: www.pepsic.bvsalud.org/pdf/per/v24n1/v24n1a06.pdf
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2.Yin Z, Puradireja DI, Abel G. Truancy and teenage pregnancy in English adolescent girls: can we identify those at risk? J Public Health.2016; 38(2):323-339. doi: https://doi.org/10.1093/pubmed/fdv29
3.Kaphagawani NC, Kalipine E. Sociocultural factors contributing to teenage pregnancy in Zomba District, Malawi. GlobPublic Health.2016; 12(6):694-710. doi: https://doi.org/10.1080/171441692.2016.122.9354
4.Alves JSA, Gama SGN; Viana MCM, Guidolini MK, Santos Neto ET. Características socioeconômicas influenciam as atitudes face à sexualidade em adolescentes, J Hum Growth Dev.2021; 31(1):101-115. doi: https://doi.org/10.36311/jhgd.v31.11084
5.Wado YD, Sully EA, Numah JN. Pregnancy and early motherhood among adolescents in five East African countries: a multi-level analysis of risk and protective factors. BMC Pregnancy Childbirth.2019; 19:59. doi: https://doi.org/10.1186/s12884-019-2204-2
6.Habito CM, Vaughan C, Morgan A. Adolescent sexual initiation and pregnancy: what more can be learned through further analysis of the demographic and health surveys in the Philippines? BMC Public Health.2019; 19(1142). doi: https://doi.org/10.1186/s12889-019-7451-4
7. Agbor VN, Mbanga CM, Njim J. Adolscent deliveries in rural Cameroon: an 8-year trend, prevalence and adverse moternofetal outcomes. Reprod Health. 2017; 14(1):122. doi: https://doi.org/10.1186/s12978-017-0382-6.
8.Brasil. Ministério da Saúde. Secretaria de Atenção em Saúde. Departamento de Ações Programáticas Estratégicas. Prevenção de gravidez na adolescência é tema de campanha nacional. Brasília: Ministério da Saúde, 2020. [Acesso em 03 maio 2022]. Disponível em: https://bvsms.saude.gov.br/01-a-08-02-semana-nacional-de-prevencao-da-gravidez-na-adolescencia/
9.Brasil. Estatuto da Criança e do Adolescente. Sanção do Artigo 8o /2019. [Acesso em 03 maio 2022]. Disponível em: https://www.gov.br/mdh/pt-br/centrais-de-conteudo/crianca-e-adolescente/estatuto-da-crianca-e-do-adolescente-versao-2019.pdf
10.Ribeiro JF, Passos AC, Lira JAC, Silva CC, Santos PO, Fontinele AVC. Complicações Obstétricas em adolescentes atendidas em uma maternidade pública de referência. Rev. Enferm UFPE. (Online). 2017; 11(7):2728-35. doi: https://doi.org/10.34119/bjhrv3n1-069
11.Gausman H, Langer A, Austin SB, Subramanian SU. Contextual variation in Early Adolescent Childbearing: A Multilevel Study From 33,822 Communities in 44 Low and Middle- Income countries. J Adolesc Health. 2019; 64:737-745. doi: https://doi.org/10.1016/j.jadohealth.2018.11.018
12.Kefale B, Yalew M, Damte Y, DamteY, Adane B. A Multilevel Analysis of Factors Associated with Teenage Pregnancy in Ethiopia. Intern. J Women´s Health.2020; 12:785-793. doi: https://doi.org/10.2147/IJWH.S265201
13.Moher D; Liberati A; Tetzalaff J; Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi: https://doi.org/10.1016/j.ijsu.2010.02.007
14.Amoran EO. A comparative analysis of predictors of teenage pregnancy and us prevention in a rural town in Western Nigeria. Int J Equity Health.2012; 11(1):37. doi: https://doi.org/10.1186/1475-9276-11-37
15.Ochen AM, Chi PC, Lawoko S. Predictors of teenage pregnancy among girls aged 13-19 years in Uganda: acommunity based case-control study. BMC Pregnancy Childbirth.2019; 19(1):211. doi: https://doi.org/10.1186/s12884-019-2347-Y
16.Muchunu G, Peltzer K, Tutshana B, Surtlwadi L. Adolescent pregnancy and associated factors in South African youth. African Health Sciences.2012; 12(4):426-434. doi: https://doi.org/10.4314/ahs.V12i4.5
17.Amoo EO, Igbinoba A, Imbonopi D, Solanke LB. Trends, Determinants and health risks of adolescent fatherhood in Sub-Saharan África. Ethiop J Health Sci. 2018; 28(4):433.doi:https://doi.org/10.4314/ejhs.v28i4.9
18.Garfield CF, Duncan G, Peters S, Rutsohn J, McDade JW, Adams EK et al. Adolescent Reproductive Knowledge, attitude, and beliefs and future fatherhood. J Adolesc Health.2016; 58(5):497-503.doi: https://doi.org/10.1016/j.jadohealth.2015.12.010
19.Exavery A, Kanti AM, Meema S, Philips JF, Masanja H. Multilevel analysis of childbirth in childhood in Tanzânia in Ruffiti District. Matern Child Health J.2016; 20(2): 447-455. doi: https://doi.org/10.1007/s10995-015-1842-7
20.Panova OV, Kulikov AM,Berchtold A, Suris JC. Factors associated with unwanted pregnancy among adolescents in Russia. J Pediatr Adolesc Gynecol.2016; 29(5):501-505. doi: https://10.1016/j.jpag.2016.04.004
21.Izugbara C. Socio-demographic risk factors for unintended pregnancy among unmarried adolescent Nigerian girls. S Afr Fam Pract.2015; 57(2):121-125. doi: https://doi.org/10.1080/20786190.2014.977042
22.Espinel-Flores V, Gotsens M, Pierg-Barrachina V, Gómez BBL, Perata A, Pérez F. Trend in teenage in Ecuador: challenges and inequalities. Int. J Public Health.2020; 65(9):1647-55. doi: https://doi.org/10.1007/s00038-020-01517-w
23.Okigbo CC, Speizer HS. Determinants of Sexual activity and Pregnancy among Unmarried Young women in Urban Kenya: Across-sectional study. PLosONE.2015; 10(6)e0129286. doi: https://doi.org/10.1371/journal.pone.0129286
24.Maness SB, Buhi ER, Daley EM, Baldwin JA, Kramrey JD. Social Determinants of Health and Adolescent Pregnancy: An Analysis from the National Longitudinal Study of Adolescent.2016; 58:636-643. doi: https://doi.org/10.1016/j.jadohealth.2016.02.006
25.Uwizeye D, Muhayitito R, Kantarama E, Wilheler S, Murangwa Y. Prevalence of teenage pregnancy and the associated contextual correlates in Rwanda. Heliyon. 2020; 6:e05037. doi: https://doi.org/10.1016/j.heliyon.2020.e05037
26. Acosta-Varela M, Cárdenas-Ayala VM. EL embarazo en adolescentes factors sócio culturales. Rev. Med. Inst. Mex. Seguro Soc. 2012; 50(4):371-374. Disponível em: https://www.redalyc.org/articulo.oa?id=457745496006
27. Ayele BG/Kidan, Gebregziabher TG, Hailu TT, Assefa BA. Determinants of teenage pregnancy in Degrea Timbien District, Tigray, Northern Ethiopia: A community based case-control study. PLoS One.2018; 13(7):e0200898. doi: https://doi.org/10.1371/journal.pone.0200898
28.Mezmur H, Assefa N, Alemayehu T. Teenage Pregnancy and its Associated Factors in Eastern Ethiopia: A Community-Based Study. Int. J Women´s Health. 2021; (13):267-278.doi: https://doi.org/10.2147/IJWH.S287715
29. Habitu YA, Yalew A, Bisetegen TA. Prevalence and Factors Associated with Teenage Pregnancy, Northeast Ethiopia 2017: A Cross-Sectional Study. J Pregnancy (Online).2018. doi: https://doi.org/10.1155/2018/1714527
30.Christofides NJ, Jeweks RK, Dunker KL, Mccarty F, Shai NJ, Nauma M, et al. Risk factors for unplanned and unwanted teenage pregnancies occurring over two years of follow up among a cohort of young South African women. Glob. Health Action.2014; 7:23719. doi: https://doi.org/10.3402/gha.v7.23719
31.Jonas K, Crutzen R, Borne B, Sewpaul R, RiddyP.Teenage pregnancy rates and association with other health risk behaviors: a three-wave cross sectional studyamong.South African school going adolescents. Reprod Health.2016; 13(1):50.doi: https://doi.org/10.1186/s12978-016-0170-8
32.Brahmbhaltt H, Kagesten A, Emerson M, Decker M, Olumed A, Ojingbede O, et al. Prevalence and determinants of adolescent pregnancy in urban, disadvantaged settings across cities. J Adolesc Health.2014; 55(60):548-557. doi: https://doi.org/10.1016/j.jadohealth.2014.07.023
33.Vásquez-Nava F, Vásquez-Rodriguez CF, Saldívar-González AH, Vásquez-Rodriguez EM, Córdova-Fernández JA, Felizardo AJ, Sánchez-Márquez W. Unplanned Pregnancy in Adolescence: Association with Family Structure, Employed Mother, and Female Friends with health risks habits and behaviors. J Urban Health.2013; 9(1):176-185. doi: https://doi.org/10.1007/s11524-013-9819-6
34. Móron-Duarte SL, Latorre C, Tavar JR. Risk factors for adolescent pregnancy in Bogotá, Colombia, 2010: a case control study. Rev. PanamSalud. Publica. .2014; 36(3):179-84. Disponível em: https://www.scielosp.org/article/rpsp/2014v36n3/179-184/
35.Bekalau Gk, Habitamu GB, Alemu DB. Teenage pregnancy and its associated factors among teenage females in frartaworeda, Northwest, Ethiopia. 2020: A community based cross-sectional study. Popul. Med.2021; 3:19. doi: https://doi.org/10.18332/popmed/139190
36. Zamora MHRN. Desigualdade racial, racismo e seus efeitos. Fractal, Ver. Psicol. 2012; 24(3)doi: https://doi.org/10.1590/S1984-02922012000300009
37. Moura FS, Júnior JAS, Rolim ACA, Silva KL, Jacob LMS. Determinantes sociais da saúde associados à gravidez na adolescência. R. Saúde Públ. Paraná. 2021; 4(1):133-150. doi: https://doi.org/10.32811/25954482-2021v4n1p133
38.Aguia-Rojas K, Ardila ADG, Bonella MVE, Rodriguéz-Niño JN. Individual and Contextual factors associated with teenage pregnancy in Colombia: A multilevel analysis. Matern Child Health J.2020; 24(11):1376-86. doi: https://doi.org/10.1007/s10995-020-02997-1
39.Islam MM, Islam MK, Hasan MS, Hossan MB. Adolescent motherhood in Bangladesh: Trend and determinants. PLosONE.2017; 12(11)e0188294. doi: https://doi.org/10.1371/journal.pome.0188294
40.Rodríguez-Vignoli J, Cavenaghi S. Adolescent and youth fertility and social inequality in Latin America and the Caribbean: what role has education played? GENUS.2015; 70(1):1-25. Disponível em: https://www.jstor.org/stable/genus.70.1.1
41.Nunes TGR, Pontes FAR, Silva LIC, Dell'aglio DD. Fatores de risco e proteção na escola: Reprovação e expectativa de futuro de jovens paraenses. Revista Quadrimestral da Associação Brasileira de Psicologia Escolar e Educacional.2014; 18(2):203-210. doi: https://doi.org/10.1590/2175-3539/2014/0182732
42. Shackleton N, Jamal F, Viner R, Dickson K, Hinds K, PATTON G, BONELL C. Systematic Review of reviews of observational studies of school level effects on sexual health, violence and substance use. Health&Place.2016; 39: 168-176. doi: https://doi.org/10.1016/j.healthplace.2016.04.002
43. Dudovitz RN, Chung PJ, Nelson B, Wong MD. What to be when you grow up? Career aspiration as marker for adolescent wellbeing. Acad Pediatr.2017; 17(2):153-160. doi: https://doi.org/10.1016/j.acap.2016.08.006
44. Zappe JG, Alves CF, Dell’aglio DD. Comportamentos de risco na adolescência: Revisão sistemática de estudos empíricos. Psicol. Rev. 2018; 24(1):79-100. Disponível em: www.pepsic.bvsalud.org/pdf/per/v24n1/v24n1a06.pdf
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Publicado
2022-09-13
Como Citar
1.
Vilar CMLN, Santos AP, Santos IN, Laureano FGBB, Colares V, Menezes VA, Santos CFBF. Fatores da desigualdade social e a sua associação com a gravidez na adolescência: uma revisão integrativa. Revista de Saúde Pública do Paraná [Internet]. 13set.2022 [citado 23nov.2024];5(3):1-8. Available from: http://revista.escoladesaude.pr.gov.br/index.php/rspp/article/view/629
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