Adolescent experiences during perinatal care in the COVID-19 pandemic: synthesis of qualitative studies

Objectives: To understand how the perinatal care experiences among adolescents were impacted during the early years of the COVID-19 pandemic. Study design: Integrative review. Methods: We performed a search in the literature focusing on qualitative studies regarding the perceptions of pregnant adolescents during the pandemic (2020-2023). We described the most frequent thematic axes observed in the included studies, and we synthesized the results. Results: The selection involved 69 articles, resulting in 9 studies from 7 countries (Indonesia, Kenya, the United Kingdom, South Africa, the United States, Malawi, and India). The studies highlight six main thematic axes: 1. Economic impact: the pandemic adversely influenced personal and family conditions, leading to early marriages and violence and exacerbating pre-existing economic inequalities. 2. Mental health: increased anxiety, depression, isolation, and fear among pregnant adolescents, with a focus on concerns related to contamination and perinatal uncertainties. 3. Compromised perinatal care: restrictions during prenatal and delivery care and lack of emotional and professional support lead to negative impacts on care for pregnant adolescents. 4. Breakdown of family Support network: school closures, family losses, and increased domestic violence affected family dynamics, influencing the occurrence of early pregnancies. 5. Impact on sexual education: school closures hindered access to contraceptives, contributing to unplanned pregnancies. 6. Vaccine hesitancy: misinformation led to hesitancy among pregnant women, highlighting the need for better communication to increase confidence in vaccination. Conclusions: The review emphasizes the wide geographic variety of the studies and highlights the interconnection between economic, social, and mental health factors. The pandemic intensified preexisting challenges, underscoring the importance of comprehensive support for pregnant adolescents, including emotional and psychological support. The COVID-19 pandemic exacerbated social and economic inequalities, negatively impacting the perinatal experiences of pregnant adolescents. The emphasis is on the need for comprehensive support, considering psychosocial factors, highlights the importance of more inclusive and sensitive health policies addressing the specific needs of this group during public health crises. The identified thematic axes, spanning economic, mental health, perinatal care, family support networks, sexual education, and vaccine hesitancy, illuminate the intricate challenges faced by adolescents during the pandemic. The identification of these axes provided a comprehensive analysis of the diverse consequences experienced by adolescents during the COVID-19 pandemic. It also allows the proposition of tailored interventions to mitigate the adverse effects on adolescent wellbeing and inform public health strategies for future pandemics or crises. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4. 0/).