Adoleszente Mutterschaft
Entwicklungsrisiken für die Mutter-Kind-Dyade
Abstract
Jugendliche Mütter und ihre Kinder sind multiplen psychosozialen Risikofaktoren ausgesetzt und stellen eine Hochrisikogruppe für ungünstige Entwicklungsverläufe dar. Psychosoziale Risiken wie Armut, Gewalterfahrungen, dysfunktionale familiäre Beziehungen oder eine psychiatrische Erkrankung, die die Entstehung einer Schwangerschaft im Teenageralter begünstigen, und die erheblichen Belastungen, die eine Elternschaft während der eigenen Entwicklungssituation in der Adoleszenz mit sich bringt, tragen eher zu den Entwicklungsrisiken der Kinder adoleszenter Mütter bei als das Alter der Mutter allein. Konsequenzen früher Mutterschaft können niedrigere Bildung und materielle Unsicherheit sein. Ebenso liegt ein erhöhtes Risiko für Psychopathologie sowohl bei den adoleszenten Müttern als auch bei den Kindern vor. Dieser Artikel soll einen Überblick über den aktuellen Forschungsstand geben. Es werden Risikofaktoren für frühe Mutterschaft erörtert und diese in Zusammenhang mit dem Erziehungsverhalten adoleszenter Mütter und den Entwicklungsverläufen ihrer Kinder gesetzt. Im Anschluss werden einige Interventionsprogramme für adoleszente Mütter und ihre Kinder vorgestellt. Weitere Forschung ist nötig, um altersangemessene Unterstützungsangebote für jugendliche Mütter und ihre Kinder zu entwickeln, die der Komplexität der Risiken gerecht werden und die Entwicklungsverläufe positiv beeinflussen.
Adolescent mothers and their children are exposed to multiple psychosocial risk factors and represent a high-risk group for adverse developmental outcomes. It is not the mother’s young age alone which contributes to the developmental risk of the mother-child dyad. Rather, both the combination of risks, such as poverty, domestic violence, dysfunctional family relationships, or a psychiatric disorder, all of which predispose to adolescent pregnancy, as well as the strains of parenthood during the mother’s own developmental stage add to the psychosocial risks of children of teenage mothers. Early motherhood can lead to lower levels of education and a lower socioeconomic status. In addition, there is a higher risk for psychopathology in both the teenage mother and her child. This article provides an overview of the current research findings regarding adolescent parenting and its associated risks. Risk factors leading to early motherhood are reviewed and associated with differences in parenting behaviors and the developmental outcomes of their children. This article will conclude with a short overview on intervention programs for adolescent mothers and their children. Further research is needed to develop age-appropriate support programs for adolescent mothers and their children to cope with the complexity of risks and improve their developmental trajectories.
Literatur
2007). The association of major depression, conduct disorder, and maternal overcontrol with a failure to show a cortisol buffered response in 4-month-old infants of teenage mothers. Biological Psychiatry, 62, 573–579.
(2003). Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin, 129, 195–215.
(2009). Schwangerschaft bei minderjährigen Müttern – Eine Risiko-Schwangerschaft? Eine Analyse der Geburtsakten der Jahrgängen 1993–2000 (Unveröffentlichte Dissertation). Universität Rostock.
(2011). Individual and group based parenting programmes for improving psychosocial outcomes for teenage parents and their children. Cochrane Database of Systematic Reviews, 3, CD002964.
(1996). Depressive symptoms, stress, and social support in pregnant and postpartum adolescents. Archives of Pediatrics and Adolescent Medicine, 150, 64–69.
(2007). Exposure to neonatal separation stress alters exploratory behavior and corticotropin releasing factor expression in neurons in the amygdala and hippocampus. Developmental Neurobiology, 67, 617–629.
(2009). Jugendliche Schwangere und ihre Partner. In , Schwangerschaft und Schwangerschaftsabbruch bei minderjährigen Frauen (Forschung und Praxis der Sexualaufklärung und Familienplanung, Band 32, S. 41–58). Köln: BzgA.
(2004). Sexual trajectories of abused and neglected youths. Journal of Developmental and Behavioral Pediatrics, 25, 77–82.
(2002). Epidemiology of depression throughout the female life cycle. The Journal of Clinical Psychiatry, 63(Suppl. 7), 9–15.
(2012). Maternal cortisol over the course of pregnancy and subsequent child amygdala and hippocampus volumes and affective problems. Proceedings of the National Academy of Sciences of the United States of America, 109, E1312–1319.
(1996). Psychopathology in adolescent mothers and its effects on mother-infant interactions: A pilot study. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 41, 379–384.
(2012). Brief report: Pregnant by age 15 years and substance use initiation among US adolescent girls. Journal of Adolescence, 35, 1393–1397.
(2011). Young maternal age and poor child development: Predictive validity from a birth cohort. Pediatrics, 127, e1436–1444.
(2003). The effectiveness of individual and group-based parenting programmes in improving outcomes for teenage mothers and their children: A systematic review. Journal of Adolescence, 26, 79–103.
(2009). Body size and intelligence in 6-year-olds: Are offspring of teenage mothers at risk? Maternal and Child Health Journal, 13, 847–856.
(2013). The association between teenage motherhood and poor offspring outcomes: A national cohort study across 30 years. Twin Research and Human Genetics, 16, 679–689.
(2009). Maternal age at childbirth and offspring disruptive behaviors: Testing the causal hypothesis. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 50, 1018–1028.
(2011). Pubertal timing and early sexual intercourse in the offspring of teenage mothers. Journal of Youth and Adolescence, 40, 1315–1328.
(2009). Does young maternal age increase the risk of adverse obstetric, fetal and neonatal outcomes: A cohort study. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 147, 151–156.
(2005). Early puberty and adolescent pregnancy: The influence of alcohol use. Pediatrics, 116, 1451–1456.
(2002). Interventions to reduce unintended pregnancies among adolescents: Systematic review of randomised controlled trials. British Medical Journal, 324, 1426–1435.
(2012). Maternal stress in pregnancy: Considerations for fetal development. Journal of Adolescent Health, 51, 3–8.
(1996). Adolescent mothers and child abuse potential: An evaluation of risk factors. Child Abuse and Neglect, 20, 1031–1047.
(2009). Die Stärkung der Eltern-Kind-Bindung: Frühe Hilfen für die Arbeit mit Eltern von der Schwangerschaft bis zum zweiten Lebensjahr des Kindes durch das STEEP-Programm (2. Aufl.). Stuttgart: Klett-Cotta.
(2010). Natural variations in maternal and paternal care are associated with systematic changes in oxytocin following parent-infant contact. Psychoneuroendocrinology, 35, 1133–1141.
(1999). Maternal age and educational and psychosocial outcomes in early adulthood. Journal of Child Psychology and Psychiatry, 40, 479–489.
(2006). Effects of therapeutic interventions for foster children on behavioral problems, caregiver attachment, and stress regulatory neural systems. Annals of the New York Academy of Sciences, 1094, 215–225.
(1995). Association of young maternal age with adverse reproductive outcomes. The New England Journal of Medicine, 332, 1113–1117.
(2007). Characteristics of women who deny or conceal pregnancy. Psychosomatics, 48, 117–122.
(2010). Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage. Biomed Central Public Health, 10, 63.
(2010). An investigation of plasma and salivary oxytocin responses in breast- and formula-feeding mothers of infants. Psychophysiology, 47, 625–632.
(2001). Effect of teenage pregnancy on educational disabilities in kindergarten. American Journal of Epidemiology, 154, 212–220.
(2011). Youth depression and early childrearing: Stress generation and intergenerational transmission of depression. Journal of Consulting and Clinical Psychology, 79, 353–363.
(2007). A behavior genetic investigation of adolescent motherhood and offspring mental health problems. Journal of Abnormal Psychology, 116, 667–683.
(2009). Lower CSF oxytocin concentrations in women with a history of childhood abuse. Molecular Psychiatry, 14, 954–958.
(2001). Why are children born to teen mothers at risk for adverse outcomes in young adulthood? Results from a 20-year longitudinal study. Development and Psychopathology, 13, 377–397.
(2009). Sexual risk behaviors among youth in the child welfare system. Children and Youth Services Review, 31, 990–1000.
(2005). The importance of parenting in the development of disorganized attachment: Evidence from a preventive intervention study in adoptive families. Journal of Child Psychology and Psychiatry, 46, 263–274.
(2010). Präventionsziel Kindergesundheit im Rahmen des Modellprojektes «Pro Kind». Bundesgesundheitsblatt, 53, 1180–1187.
(2011). Childhood Experiences of Care and Abuse (CECA). Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 39, 243–252.
(2009). Supporting insensitive mothers: The Vilnius randomized control trial of video-feedback intervention to promote maternal sensitivity and infant attachment security. Child: Care, Health and Development, 35, 613–623.
(2003). Pubertal timing, sexual behaviour and self-reported depression in middle adolescence. Journal of Adolescence, 26, 531–545.
(1997). Social consequences of psychiatric disorders, II: Teenage parenthood. The American Journal of Psychiatry, 154, 1405–1411.
(2013). Hirnentwicklung in der Adoleszenz: Neurowissenschaftliche Befunde zum Verständnis dieser Entwicklungsphase. Deutsches Ärzteblatt International, 110, 425–431.
(2005). Experiential and hormonal correlates of maternal behavior in teen and adult mothers. Hormones and Behavior, 47, 112–122.
(2012). Genome-wide epigenetic regulation by early-life trauma. Archives of General Psychiatry, 69, 722–731.
(2009). Depression among a sample of first-time adolescent and adult mothers. Journal of Child and Adolescent Psychiatric Nursing, 22, 194–202.
(2007). Minderjährige Schwangere in Deutschland. Statistische Daten zu Schwangerschaftsabbrüchen und Geburten. BZgA Forum, 2, 3–11.
(2011). Minderjährige Schwangere in Deutschland. Statistische Daten zu Schwangerschaftsabbrüchen und Geburten. BZgA Forum, Sonderheft 2011, 3–13.
(2010). Young mother-father dyads and maternal harsh parenting behavior. Child Abuse and Neglect, 34, 874–885.
(2012). Childhood predictors of becoming a teenage mother among Finnish girls. Acta Obstetricia et Gynecologica Scandinavica, 91, 1319–1325.
(2001). Academic and behavioural outcomes among children of young mothers. Journal of Marriage and Family, 63, 355–369.
(2004). Adolescent mothers: Support needs, resources, and support-education interventions. The Journal of Adolescent Health, 35, 509–525.
(2011). Young adult outcomes of children born to teen mothers: Effects of being born during their teen or later years. Journal of the American Academy of Child and Adolescent Psychiatry, 50, 232–241.
(2013). Psychosocial stress during pregnancy is related to adverse birth outcomes: Results from a large multi-ethnic community-based birth cohort. European Journal of Public Health, 23, 485–491.
(2006). The potential for child neglect: The case of adolescent mothers and their children. Child Maltreatment, 11, 281–294.
(2000). Maternal depression and parenting behavior: A meta-analytic review. Clinical Psychology Review, 20, 561–592.
(2011). Larger amygdala but no change in hippocampal volume in 10-year-old children exposed to maternal depressive symptomatology since birth. Proceedings of the National Academy of Sciences of the United States of America, 108, 14324–14329.
(2011). Reported early family environment covaries with menarcheal age as a function of polymorphic variation in estrogen receptor-α. Development and Psychopathology, 23, 69–83.
(2010). History of childhood abuse is accompanied by increased dissociation in young mothers five months postnatally. Psychopathology, 43(2), 104–109.
(2009). Die empirischen Studien. In , Schwangerschaft und Schwangerschaftsabbruch bei minderjährigen Frauen (Forschung und Praxis der Sexualaufklärung und Familienplanung, Bd. 32, S. 29–38). Köln: BzgA.
(2004). The impact of physical maltreatment history on the adolescent mother-infant relationship: Mediating and moderating effects during the transition to early parenthood. Journal of Abnormal Child Psychology, 32, 249–261.
(2006). Emotional stress in pregnancy predicts human infant reactivity. Early Human Development, 82, 731–737.
(2007). A systematic review of dietary assessments of pregnant adolescents in industrialised countries. The British Journal of Nutrition, 97, 411–425.
(2005). The relationships of dissociation and affective family environment with the intergenerational cycle of child abuse. Child Abuse and Neglect, 29, 683–699.
(2012). Perinatal conditions and parental age at birth as risk markers for subsequent suicide attempt and suicide: A population based case-control study. European Journal of Epidemiology, 27, 729–738.
(2009). Interventions for preventing unintended pregnancies among adolescents. Cochrane Database of Systematic Reviews, 4, CD005215.
(1988). A comparison of childhood backgrounds of teenage mothers and their non-mother peers: A new formulation. Journal of Adolescence, 11, 251–261.
(2012). Geburten in Deutschland. Ausgabe 2012. Wiesbaden: Statistisches Bundesamt.
(2011). Adolescent motherhood and developmental outcomes of children in early head start: The influence of maternal parenting behaviors, well-being, and risk factors within the family setting. The American Journal of Orthopsychiatry, 81, 228–245.
(2012). Wirkungsevaluation «Keiner fällt durchs Netz». Ein Modellprojekt des Nationalen Zentrums Frühe Hilfen. Bundesinitiative Frühe Hilfen Kompakt. Köln: NZFH.
(2009). Ungeplantes Glück. Deutsche Hebammenzeitschrift, 9, 72–74.
(2011). Prenatal stress and infant affective reactivity at five months of age. Early Human Development, 87, 129–136.
(2012). Adolescent childbearing: Consequences and interventions. Current Opinion in Pediatrics, 24, 446–452.
(2009). Approaching the adolescent-headed family: A review of teen parenting. Current problems in Pediatric and Adolescent Health Care, 39, 216–233.
(2006). Jugendschwangerschaften in Deutschland. Zeitschrift für Sexualforschung, 19, 334–373.
(2002). Association of early childbearing and low cognitive ability. Perspectives on Sexual and Reproductive Health, 34, 236–243.
(2012). Das exzessive Schreien bei 5 Monate alten Säuglingen und prä-, peri- und postnatale Belastungen ihrer Mütter in einer Hoch-Risiko-Stichprobe. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 40, 239–250.
(2011). Frontostriatal maturation predicts cognitive control failure to appetitive cues in adolescents. Journal of Cognitive Neuroscience, 23, 2123–2134.
(2010). Latent growth trajectories of substance use among pregnant and parenting adolescents. Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors, 24, 322–332.
(2010). Erste Ergebnisse zur Wirksamkeit Früher Hilfen aus dem STEEP-Praxisforschungsprojekt «WiEge». Bundesgesundheitsblatt, 53, 1143–1149.
(1999). Corticotropin-releasing hormone and cortisol: longitudinal associations with depression and antisocial behavior in pregnant adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 460–467.
(2004). Early motherhood and disruptive behaviour in the school-age child. Acta Paediatrica, 93, 120–125.
(2001). A league table of teenage births in rich nations. Innocenti Report Card 3. Florenz: UNICEF Innocenti Research Centre.
. (2012). Table 10. Live births by age of mother and sex of child, general and age-specific fertility rates: Latest available year, 2002–2011. Verfügbar unter unstats.un.org/unsd/demographic/products/dyb/dyb2011.htm
. (2007). Denial of pregnancy – Characteristics of women at risk. Acta Obstetricia et Gynecologica Scandinavica, 86, 542–546.
(2012). Epigenetic mechanisms for the early environmental regulation of hippocampal glucocorticoid receptor gene expression in rodents and humans. Neuropsychopharmacology, 38, 111–123.
(2007). Förderung der Beziehungs- und Erziehungskompetenzen bei jugendlichen Müttern. Praxis der Kinderpsychologie und Kinderpsychiatrie, 56, 660–675.
(2004). Frühe Förderung von Resilienz bei jungen Müttern und ihren Säuglingen. Kindheit und Entwicklung, 13, 226–234.
(