ISSN 3028-8940
JULY-DECEMBER 2025;2(2):79-91
O
RIGINAL ARTICLE https://doi.org/10.36097/rgcs.v2i2.3186
San Gregorio de Portoviejo University | Ecuador 79
Social determinants associated with teenage pregnancy in the 24 de Mayo community in
Ecuador
Determinantes sociales asociados al embarazo en adolescentes en la comunidad 24 de Mayo en Ecuador
José D. Barcia
1
, Alisson L. Bravo
1
, Renata M. Leones
1
, Valeria I. Mendoza
1
*
Helen Z. Veliz
1
, José A. Cedeño
1
, Reisey Batista
2
1
Carrera de Medicina, Universidad San Gregorio de Portoviejo, Manabí, Ecuador.
2
Hospital Básico Chone, Instituto Ecuatoriano de Seguridad Social, Manabí, Ecuador.
*Corresponding author
Reception: 07-05-2025 Acceptance: 02-07-2025 Publication: 31-07-2025
ABSTRACT
Adolescent pregnancy is a significant public health concern with social, economic, and educational repercussions.
This study aimed to describe the social determinants associated with teenage pregnancy in the 24 de Mayo community,
Manabí, Ecuador. An observational, descriptive, and cross-sectional study was conducted from April to September
2023, during which surveys were administered to 30 community members to assess factors such as sexual education,
family background, and contraceptive use. Results showed that 80% of respondents had a family history of adolescent
pregnancy, 63.3% considered sexual education insufficient, and 90% did not use contraceptives. Early sexual initiation
and limited institutional engagement were also observed. The study concludes that implementing educational
strategies, enhancing access to comprehensive sexual education, and reinforcing family planning are essential to
reduce the prevalence of adolescent pregnancy and its intergenerational consequences.
Keywords: adolescent pregnancy, sexual education, contraception, public health, social determinants.
RESUMEN
El embarazo adolescente constituye un grave problema de salud pública que afecta el bienestar social, económico y
educativo de las comunidades. Este estudio tuvo como objetivo describir los determinantes sociales asociados al
embarazo en adolescentes de la comunidad 24 de Mayo, en Manabí, Ecuador. Se realizó un estudio observacional,
descriptivo y transversal entre abril y septiembre de 2023, en el cual se aplicaron encuestas a 30 personas de la
comunidad para analizar aspectos como la educación sexual, los antecedentes familiares y el uso de métodos
anticonceptivos. Los resultados revelaron que el 80 % de los participantes tenía antecedentes familiares de embarazo
adolescente, el 63,3 % consideraba insuficiente la educación sexual recibida y el 90 % no utilizaba anticonceptivos.
Asimismo, se observó una iniciación sexual temprana y una percepción comunitaria de escasa intervención
institucional. Se concluye que es indispensable implementar estrategias educativas, mejorar el acceso a la educación
sexual integral y fortalecer la planificación familiar, con el fin de reducir la incidencia del embarazo adolescente y sus
efectos intergeneracionales.
Palabras clave: embarazo adolescente, educación sexual, anticoncepción, salud pública, determinantes sociales.
Cite as: Barcia, J. D., Bravo, A. L., Leones, R. M., Mendoza, V. I., Veliz, H. Z., Cedeño, J. A., & Batista, R. (2025). Social
determinants associated with teenage pregnancy in the 24 de Mayo community in Ecuador. Revista Gregoriana de Ciencias de la
Salud, 2(2), 79-91. https://doi.org/10.36097/rgcs.v2i2.3186
© Author(s) 2025
Social determinants associated with teenage pregnancy in the 24 de Mayo community in Ecuador
Barcia, Bravo, Leones, Mendoza, Veliz, Cedeño, & Batista
80 San Gregorio de Portoviejo University | Ecuador
INTRODUCTION
Adolescence is a transitional period between childhood and adulthood, marked by
significant physical, psychological, and social changes. During this stage, the experience of
sexuality becomes more evident, often marked by unprotected sexual practices due to a lack of
information and communication among family members, as well as the myths and taboos
surrounding the topic. These conditions make adolescents a vulnerable group to risky situations,
including pregnancy (Santos et al., 2017).
The first sexual experience is a significant factor in adolescent childbearing trends. Often,
these relationships lack full consent or adequate contraceptive use, increasing the risk of unplanned
pregnancies. Furthermore, factors such as socioeconomic status, limited access to contraception,
and gender inequalities profoundly impact adolescents' reproductive health (Espinel-Flores et al.,
2020).
In Latin America and the Caribbean, the adolescent fertility rate is one of the highest in the
world, surpassed only by sub-Saharan Africa. Approximately 30% of women in the region become
mothers before turning 20, and this trend has been increasing since 1990, despite a decline in
overall fertility (Rodríguez, 2016). In Ecuador, the problem is particularly alarming as 1,921 live
births were recorded in 2022 to mothers aged 10 to 14, corresponding to 2 live births per 1,000
women in that age range, and 38,087 live births to mothers aged 15 to 19, a rate of 47.3 live births
per 1,000 women in this age group (Instituto Nacional de Estadística y Censos [INEC], 2023). This
situation reflects the persistence of factors such as limited access to contraceptive methods, a lack
of comprehensive sexuality education, and social inequalities, which contribute to perpetuating
this problem in the country.
The proximate determinants of adolescent fertility, such as access to contraception, the
legality of abortion, and comprehensive sexuality education, are key to understanding this issue.
In countries where contraceptive use is almost universal, such as Spain, adolescent fertility rates
are significantly lower. However, in contexts like Ecuador, social taboos, a lack of information,
and sexual violence contribute to perpetuating this situation (Rodríguez, 2016).
Despite advances in urbanization and education, first-time pregnancies among adolescents,
especially those from lower socioeconomic backgrounds, have not decreased. Early motherhood
Revista Gregoriana de Ciencias de la Salud. Bi-annual peer-reviewed publication. ISSN 3028-8940 / July-December 2025;2(2):79-91
San Gregorio de Portoviejo University | Ecuador 81
negatively impacts the health and education of young mothers, perpetuates intergenerational
poverty, and deepens gender inequality. It has been reported that the effects of adverse
socioeconomic conditions, such as teenage pregnancy, not only impact youth but can also affect
the quality of life in later stages, such as adulthood or old age, by limiting access to education and
employment (Angulo et al., 2024).
In this context, this article aimed to analyze the determinants associated with teenage
pregnancy in the 24 de Mayo canton of Manabí, Ecuador. Personal, familial, socioeconomic, and
cultural aspects will be analyzed to provide a basis for developing effective prevention strategies
that promote the well-being of adolescents and guarantee their right to a healthy and fulfilling life.
METHODOLOGY
An observational, descriptive, qualitative, and cross-sectional study was conducted to
analyze relevant information from our knowledge integration project, identifying key factors
influencing teenage pregnancy in the 24 de Mayo canton, Manabí, Ecuador. The study was
conducted between April and September 2023.
Data collection involved administering a six-question survey to 30 community members.
The questions addressed sexual education, family issues, and educational level to determine
awareness of this issue in the area. This survey was conducted in conjunction with health
professionals to ensure the quality of the responses and results, allowing us to address the social
determinants associated with teenage pregnancy.
Quantitative data were collected through in-person surveys, while qualitative data were
obtained through interviews and observation at the health center and in the community. The
quantitative data were analyzed using Excel, where descriptive analyses, such as frequencies and
percentages, were applied to sociodemographic and health variables. The qualitative data were
analyzed using a content analysis approach.
This study strictly adhered to the ethical principles of health research. The privacy and
anonymity of participants were ensured at all times. Data were treated confidentially, and the
results were presented without any form of personal identification.
Social determinants associated with teenage pregnancy in the 24 de Mayo community in Ecuador
Barcia, Bravo, Leones, Mendoza, Veliz, Cedeño, & Batista
82 San Gregorio de Portoviejo University | Ecuador
RESULTS AND DISCUSSION
This study highlights the intricate relationship between socioeconomic and health factors
that contribute to teenage pregnancy in the 24 de Mayo community. The results of the survey
conducted among 30 community residents reveal important information about the living conditions
and health challenges faced by community members. Table 1 shows the age distribution at which
respondents report starting their sexual life. It can be seen that 30% of the surveyed population
began their sexual life between the ages of fourteen and sixteen, while 70% did so between sixteen
and eighteen.
Table 1. Consolidated data on adolescent pregnancy (n = 30)
Variable
Category
Frequency
Percentage
Main implications
Age at first sexual
intercourse
14–16 years 9 30
Early initiation requires sexual
education starting at early school
levels.
16–18 years 21 70
Confirms regional trend: most
adolescents begin sexual activity
before age 18.
Family history of
teenage pregnancy
Yes 24 80
Indicates intergenerational
normalization of adolescent
pregnancy.
No 6 20
Minorities without family
precedent may experience a
protective effect.
Main factors
influencing adolescent
pregnancy
Lack of
sexual
education
19 63.3
Urgent need for comprehensive
sexuality education programs.
Family
problems
11 36.7
Family dynamics directly impact
reproductive decisions.
Use of contraceptive
methods
Yes 3 10
Very low usage suggests lack of
access, information, or presence
of taboos.
No 27 90
Immediate action needed to
improve access and promote
responsible contraceptive use.
Willingness to
implement prevention
tools in community
Yes 18 60
Community is receptive to
preventive strategies and
educational outreach.
No 12 40
A portion of the community still
does not prioritize adolescent
pregnancy prevention.
Revista Gregoriana de Ciencias de la Salud. Bi-annual peer-reviewed publication. ISSN 3028-8940 / July-December 2025;2(2):79-91
San Gregorio de Portoviejo University | Ecuador 83
In this sense, early sexual initiation constitutes a risk factor for adolescent health, since
inaccurate preventive education can lead to sexually transmitted infections (STIs) or even an
increase in unplanned pregnancies at this stage.
These data highlight the importance of sexual education from an early age. Although a
significant percentage of adolescents begin their sexual life after the age of 16, there is still a
considerable group that does so before that age. This underscores the need to address issues such
as preventing unwanted pregnancies and sexually transmitted diseases, especially among
adolescents who may not be fully prepared to handle the emotional and physical implications of
sexual activity. This approach is consistent with the findings of Altamirano and Sandoval (2023),
who indicate that first sexual intercourse begins at an increasingly earlier age. However, the real
problem lies in the lack of guidance and adequate knowledge about responsible and healthy sexual
behavior, with knowledge about contraceptive methods being essential.
In the North American region, 62.8% of adolescents are sexually active and 850,000
students become pregnant each year, estimating that this occurs during the first sexual encounter
due to the lack of information and tools, linking it to a percentage of 20% of induced abortions
(Committee on Adolescence et al., 2014).
In Latin America, descriptive studies show that the majority of the population begins their
sexual life before the age of 18. However, access to and knowledge about contraception are
inadequate. Ecuador is among the countries with the lowest access and lowest levels of sexual
education, surpassed only by Venezuela and Colombia (Chiliquinga et al., 2021).
A total of 24 respondents, representing 80% of the sample, reported that there are or have
been cases of teenage pregnancy within their families. This indicates that this may be a common
situation within these families and may be reflected as a social determinant for future generations.
This is because early pregnancy is normalized, and family planning is not followed.
This high prevalence suggests a normalization of early childbearing within family
structures, which could decrease the perceived risks associated with adolescent pregnancy and
reduce the motivation to seek or use contraception. This intergenerational pattern underscores the
absence of effective preventive models within the community. Espinel-Flores et al. (2020) found
similar influences of the family and social environment on adolescents' reproductive decisions.
Social determinants associated with teenage pregnancy in the 24 de Mayo community in Ecuador
Barcia, Bravo, Leones, Mendoza, Veliz, Cedeño, & Batista
84 San Gregorio de Portoviejo University | Ecuador
The normalization of early childbearing in communities with limited opportunities may reinforce
a cycle of poverty and limited educational attainment (Rodríguez, 2016).
The normalization of teenage pregnancy in some communities can have profound and
lasting consequences. This situation not only affects the adolescents directly involved but also
impacts the family and social structure, perpetuating cycles of poverty and educational limitations.
The lack of access to comprehensive sexuality education and adequate contraception contributes
to these dynamics. It is crucial to address this problem on multiple fronts, including education,
women's empowerment, and promoting a culture that values family planning and personal
development before motherhood.
A relevant article on this topic highlights that "educating and empowering adolescent girls
are critical to reducing unintended pregnancies and improving future opportunities" (Martínez et
al., 2020). This approach suggests that investing in young women's education can break the
intergenerational cycle of teenage pregnancies and foster a brighter future for them and their
families.
The results revealed that 63.3% of respondents believe that teenage pregnancy is not
adequately addressed within their community and reported infrequent discussions in health centers
or community settings. On the other hand, 36.7% believe that family problems are the primary
driver of teenage pregnancy. This lack of open discussion translates into limited access to essential
information about contraception and family planning, which can lead to an increase in unplanned
pregnancies. The findings are consistent with the assertion of Rodríguez (2016), who pointed out
that lack of access to comprehensive sexuality education is a key determinant of adolescent fertility
in Latin America and the Caribbean. This deficiency highlights the critical need for accessible and
culturally sensitive educational programs within the community.
Comprehensive sexuality education is a fundamental component to ensuring that young
people have the information and tools necessary to exercise their right to full and responsible
sexual and reproductive health. To effectively address this issue, relevant topics such as anatomy,
sexual physiology, prevention of sexually transmitted infections (STIs), available contraceptive
methods, consent in interpersonal relationships, and the promotion of healthy and respectful
Revista Gregoriana de Ciencias de la Salud. Bi-annual peer-reviewed publication. ISSN 3028-8940 / July-December 2025;2(2):79-91
San Gregorio de Portoviejo University | Ecuador 85
emotional bonds must be included, using language appropriate for the population to be educated
(Peláez, 2016).
However, the lack of access to comprehensive sexuality education remains a significant
problem in Latin America and the Caribbean. Rodríguez (2016) points out that the absence of this
type of education is a key determinant of adolescent fertility in the region. This deficiency
highlights the need for accessible and culturally sensitive educational programs within the
community. The lack of open discussion about sexuality translates into limited access to essential
information on contraception and family planning, which can contribute to the increase in
unplanned pregnancies.
In the study by Martínez et al. (2020) in Cuba, the risk factors for teenage pregnancy were
identified as the initiation of sexual relations between the ages of 15 and 19 and the lack of
knowledge about pregnancy complications at this stage. This highlights the importance of sex
education in the family and school settings, focusing on the implementation of contraceptive
methods to prevent teenage pregnancies. Furthermore, the family environment plays a determining
role in young people's sexual behavior.
Molina et al. (2019) indicate that around 80% of teenage pregnancies occur in family
contexts characterized by a lack of communication, affection, and problematic relationships.
Martínez et al. (2020) suggest that, in some cases, teenage pregnancy may represent an attempt by
the young woman to be recognized, valued, and loved by her family, or a way to emancipate herself
from a restrictive family system. However, these attempts can generate harmful dynamics,
affecting both the mother and her environment.
On the other hand, Martínez et al. (2020) note that, on the psychosocial level, adolescents
may distance themselves from the influence of their parents or caregivers, becoming more self-
centered and believing they no longer require supervision. They often seek information about
sexuality in the media, where a vision of limitless sexual activity is presented, sometimes
associated with debauchery and violence.
Furthermore, the assertion that family problems are a key factor in teenage pregnancy
highlights its impact not only on young mothers but also on their families. Lack of emotional
Social determinants associated with teenage pregnancy in the 24 de Mayo community in Ecuador
Barcia, Bravo, Leones, Mendoza, Veliz, Cedeño, & Batista
86 San Gregorio de Portoviejo University | Ecuador
support, financial hardship, and dysfunctional family dynamics can affect adolescents' physical
and emotional well-being, limiting their access to education and economic opportunities.
Data showed that 90% of young women surveyed stated that they did not use contraceptive
methods, while 10% mentioned that they did use them. Liang et al. (2019) mentions that
adolescents are shy or embarrassed to request information regarding contraceptive methods, in
addition to the fact that in certain countries their access is limited, prohibited and very expensive
to request, however, in places where they are readily available, the adolescent population less uses
them about the adult.
It is essential to offer adolescents the broadest range of options, including emergency
contraception, while also evaluating each method in terms of biological, psychological,
socioeconomic, and family values. The best contraceptive method is the one chosen by the
adolescent, and preferably by both partners.
A proportion of community respondents (60%) agreed that it would be effective to
implement various activities to reduce or prevent teenage pregnancy within the community. This
receptivity demonstrates that the community is open to implementing comprehensive strategies
that combine sexuality education, access to contraception, and the promotion of gender equity.
Combining educational interventions with accessible reproductive health services has been shown
to reduce adolescent pregnancy rates significantly. Community engagement and culturally
sensitive approaches are essential to the success of such interventions.
Given this context, implementing comprehensive sexuality education programs is
essential. Santos et al. (2017) emphasize that adolescents' knowledge about sexually transmitted
diseases and pregnancy is directly related to the presence of educational programs in this area.
These programs should address topics such as reproductive anatomy, contraceptive methods,
sexually transmitted infections, consent, and healthy relationships, in order to provide practical
tools for responsible decision-making. Furthermore, the importance of comprehensive sexuality
education, which encompasses the development of emotions, feelings, and attitudes, as well as
intersectoral collaborative work to enhance adolescent health and well-being, has been
emphasized. Involving parents and the community in these initiatives increases their effectiveness
(Castillo et al., 2022). Campo (2024) also highlights that families with effective communication
Revista Gregoriana de Ciencias de la Salud. Bi-annual peer-reviewed publication. ISSN 3028-8940 / July-December 2025;2(2):79-91
San Gregorio de Portoviejo University | Ecuador 87
and an emotionally supportive environment are essential to preventing teenage pregnancy, arguing
that interventions in family dynamics through workshops and educational programs can
significantly reduce teenage pregnancy rates by fostering healthy and open relationships between
parents and children.
Structural determinants such as poverty, food insecurity, and limited access to basic
services play a critical role in shaping adolescents’ psychosocial and reproductive trajectories.
These conditions not only affect health and educational opportunities but also condition dietary
patterns that may reinforce cycles of vulnerability. In resource-constrained environments, food
choices are often guided by affordability rather than nutritional value, resulting in diets that are
high in energy but deficient in essential micronutrients.
In the province of Manabí, regional studies have documented that traditional dishes exhibit
a high energy density and low nutrient diversity, reflecting the adaptation of local populations to
socioeconomic limitations (Alvarado et al., 2021; Alvarado & Zambrano, 2023). Such dietary
patterns, while culturally rooted, may contribute to early physical maturation and altered health
outcomes in adolescents. These nutritional deficiencies, coupled with limited reproductive
education and scarce access to contraceptive methods, may facilitate early sexual initiation and
unplanned pregnancies. A low-antioxidant diet may impair redox balance and adolescent
reproductive health, increasing vulnerability to risk factors (Forbes-Hernández et al., 2020).
Thus, the intersection of inadequate nutrition, poverty, and educational inequalities
constitutes a latent driver of early motherhood, reinforcing intergenerational cycles of social
disadvantage. Addressing these issues requires a comprehensive approach that integrates food
security, health promotion, and culturally sensitive strategies for sexual and reproductive
education.
Table 2 presents a summary of basic descriptive statistics derived from the survey data. On
average, 18.6 respondents provided affirmative answers to key questions related to adolescent
pregnancy, reflecting a general awareness and recognition of the issue across the sample. The
standard deviation of 6.8 indicates a moderate variability in responses, suggesting that while some
variables show high consensus, others reflect more diverse opinions. The median value of 19
confirms that at least half of the variables received 19 or more positive responses. Notably, the
Social determinants associated with teenage pregnancy in the 24 de Mayo community in Ecuador
Barcia, Bravo, Leones, Mendoza, Veliz, Cedeño, & Batista
88 San Gregorio de Portoviejo University | Ecuador
most frequent response was 27, corresponding to the number of adolescents who reported not using
any contraceptive methods—a finding that underscores a critical gap in reproductive health
practices. The overall non-prevention rate of 90% highlights the urgent need for targeted
interventions aimed at improving access to and education about contraceptive methods among
adolescents.
Table 2. Basic descriptive statistical parameters (n = 30)
Indicator
Value
Interpretation
Mean of positive responses 18.6
Most of the relevant responses (on average) acknowledge the
existence of the issue.
Standard deviation (positive
responses)
6.8 Moderate dispersion across the variables of interest.
Median (positive responses)
19
Half of the variables have ≥19 affirmative responses.
Mode 27
The most frequent value corresponds to “no contraceptive
use.”
Overall non-prevention rate 90%
Reflects the percentage of adolescents not using any
contraceptive methods.
CONCLUSIONS
The research identified the social determinants that influence teenage pregnancy in the 24
de Mayo community of Manabí. It revealed that the normalization of teenage pregnancy, the lack
of comprehensive sexuality education, and low-income family communication are key factors that
prolong this problem. The community recognizes adolescent pregnancy as a preventable problem
through educational strategies and access to contraceptive methods. The research contributes to
the field of public health by providing evidence of the need for interventions aimed at preventing
teenage pregnancy. Therefore, the implementation of policies that strengthen sexuality education,
access to reproductive health services, and gender equity is essential to reducing the incidence of
this problem and ensuring better opportunities for adolescents. It is recommended that future
research further explore the factors that contribute to the normalization of teenage pregnancy in
the 24 de Mayo community. It would also be helpful to investigate the effectiveness of different
interventions for preventing adolescent pregnancy.
CONFLICTS OF INTEREST
The authors declare that they have no conflicts of interest.
Revista Gregoriana de Ciencias de la Salud. Bi-annual peer-reviewed publication. ISSN 3028-8940 / July-December 2025;2(2):79-91
San Gregorio de Portoviejo University | Ecuador 89
AUTHOR CONTRIBUTIONS
Conceptualization: José D. Barcia, Alisson L. Bravo, Renata M. Leones, Valeria I.
Mendoza, and Helen Z. Veliz. Data curation: José D. Barcia, Alisson L. Bravo, Renata M.
Leones, Valeria I. Mendoza, and Helen Z. Veliz. Formal analysis: José D. Barcia, Alisson L.
Bravo, Renata M. Leones, Valeria I. Mendoza, and Helen Z. Veliz. Investigation: José D. Barcia,
Alisson L. Bravo, Renata M. Leones, Valeria I. Mendoza, Helen Z. Veliz, José A. Cedeño, and
Reisey Batista. Methodology: José A. Cedeño and Reisey Batista. Supervision: José A. Cedeño
and Reisey Batista. Validation: José A. Cedeño and Reisey Batista. Visualization: José D.
Barcia, Alisson L. Bravo, Renata M. Leones, Valeria I. Mendoza, and Helen Z. Veliz. Writing –
original draft: José D. Barcia, Alisson L. Bravo, Renata M. Leones, Valeria I. Mendoza, Helen
Z. Veliz, José A. Cedeño, and Reisey Batista. Writing – review & editing: José D. Barcia,
Alisson L. Bravo, Renata M. Leones, Valeria I. Mendoza, Helen Z. Veliz, José A. Cedeño, and
Reisey Batista.
REFERENCES
Altamirano, A. D., & Sandoval, G. M. (2023). Conocimiento de métodos anticonceptivos en la
población adolescente. Brazilian Journal of Health Review, 6(1), 2828-2840.
https://doi.org/10.34119/bjhrv6n1-222
Alvarado, J. M., Zambrano, J. I., & García, M. A. (2021). Densidad energética nutricional de platos
típicos manabitas. QhaliKay, 5(3), 66-74. https://doi.org/10.33936/qkrcs.v5i3.3911
Alvarado, J. M., & Zambrano, J. I. (2023). Tradition and nutrition: An analysis of Manabí cuisine
and its impact on health and cultural identity. Journal of Food Science and Gastronomy,
1(2), 25-29. https://doi.org/10.5281/zenodo.13994886
Angulo, A. A., Rodríguez, D., & García, M. A. (2024). Estado nutricional y calidad de vida del
adulto mayor: revisión sistemática. Revista Gregoriana de Ciencias de la Salud, 1(2), 165-
177. https://doi.org/10.36097/rgcs.v1i2.3149
Committee on Adolescence, Braverman, P. K., Adelman, W. P., Alderman, E. M., Breuner, C. C.,
Levine, D. A., Marcell, A. V., & O’Brien, R. F. (2014). Contraception for adolescents.
Pediatrics, 134(4), e1244-e1256. https://doi.org/10.1542/peds.2014-2299
Campo, G. H. (2024). Proyecto de educación sexual integral para la promoción de la salud y
bienestar de los estudiantes del Colegio Albert Einstein, San José de Cúcuta, Norte de
Social determinants associated with teenage pregnancy in the 24 de Mayo community in Ecuador
Barcia, Bravo, Leones, Mendoza, Veliz, Cedeño, & Batista
90 San Gregorio de Portoviejo University | Ecuador
Santander [Universidad Nacional Abierta y a Distancia UNAD].
https://repository.unad.edu.co/bitstream/handle/10596/65889/ghcampoy.pdf?sequence=1
&isAllowed=y
Castillo, J., Cevallos, A., & López, N. (2022). Educación sexual en el sistema educativo para
prevenir el embarazo adolescente: estado del arte. Revista Educación las Américas, 12(1).
https://doi.org/10.35811/rea.v12i1.182
Chiliquinga, J. A., Salazar, P. B., Riofrío, S. Y., & Loaiza, D. J. (2021). Uso de métodos
anticonceptivos en jóvenes de América Latina, un aporte desde Ecuador. Revista San
Gregorio, 1(45), 158-173. https://doi.org/10.36097/rsan.v0i45.1439
Espinel-Flores, V., Gotsens, M., Puig-Barrachina, V., León-Gómez, B. B., Peralta, A., & Pérez,
G. (2020). Trends in teenage motherhood in Ecuador: Challenges and inequalities.
International Journal of Public Health, 65(9), 1647-1655. https://doi.org/10.1007/s00038-
020-01517-w
Forbes-Hernández, T. Y.; Betancourt, G.; Rodríguez, D.; García, M. A. (2020). Capacidad
antioxidante total de la dieta vs. balance redox. QhaliKay, 4(1), 35-48.
https://doi.org/10.33936/qkrcs.v4i1.2711
Instituto Nacional de Estadística y Censos [INEC]. (2023). Registro Estadístico de Nacidos Vivos
y Defunciones Fetales 2022. Estadísticas Vitales. http://bit.ly/418BGkQ
Liang, M., Simelane, S., Fillo, G. F., Chalasani, S., Weny, K., Canelos, P. S., Jenkins, L., Moller,
A. B., Chandra-Mouli, V., Say, L., Michielsen, K., Engel, D. M. C., & Snow, R. (2019).
The State of Adolescent Sexual and Reproductive Health. Journal of Adolescent Health,
65(6), S3-S15. https://doi.org/10.1016/j.jadohealth.2019.09.015
Martinez, E., Montero, G., & Zambrano, R. (2020). El embarazo adolescente como un problema
de salud pública en Latinoamérica. Revista Espacios, 41(47), 1-10.
https://doi.org/10.48082/espacios-a20v41n47p01
Molina, A., Pena, R., & Díaz, C. (2019). Condicionantes y consecuencias sociales del embarazo
en la adolescencia. Revista Cubana de Obstetricia y Ginecología, 45(2), e218.
https://www.medigraphic.com/pdfs/revcubobsgin/cog-2019/cog192q.pdf
Peláez, J. (2016). El uso de métodos anticonceptivos en la adolescencia. Revista Cubana de
Obstetricia y Ginecología, 42(1), e41
https://revginecobstetricia.sld.cu/index.php/gin/article/view/285
Revista Gregoriana de Ciencias de la Salud. Bi-annual peer-reviewed publication. ISSN 3028-8940 / July-December 2025;2(2):79-91
San Gregorio de Portoviejo University | Ecuador 91
Rodríguez, J. (2016). Adolescent fertility in Latin America and the Caribbean: Sources, trends and
patterns. United Nations Expert Group Meeting on Early Adolescent Fertility Data,
October 26–27. Latin American and Caribbean Demographic Centre (CELADE) –
Population Division of ECLAC. http://bit.ly/4mi3Nq8
Santos, R. A. A., Frazão, R. G. C., Palmeira, I. L. T., da Hora, J. M., Linard, A. G., Silva, N. P., &
Silva, S. O. (2017). Knowledge of adolescents regarding sexually transmitted infections
and pregnancy. Revista Brasileira de Enfermagem, 70(5), 1033-1039.
https://doi.org/10.1590/0034-7167-2016-0531
Disclaimer / Editor's Note: All publications' statements, opinions, and data are solely those of
the individual authors and contributors, not Revista Gregoriana de Ciencias de la Salud or the
editors. Revista Gregoriana de Ciencias de la Salud and/or the editors disclaim all responsibility
for any injury to persons or property resulting from any ideas, methods, instructions, or products
referred to in the content.
