Motherhood and mental health of adolescent girls in low- and middle-income countries: A scoping review

Abstract

Adolescence, a crucial transitional period, involves significant physical, cognitive, and psychosocial transformations. In Low- and Middle-Income Countries (LMICs), adolescent pregnancy is a significant public health concern, with an estimated 95% of the world's adolescent births occurring in these settings. While extensive research has explored various facets of adolescent development, there remains a gap in understanding mental health challenges experienced during motherhood. This scoping review aimed to assess the existing literature on the mental health of adolescent mothers in LMICs and identify gaps to guide future research and interventions in this underexplored domain. A scoping review was conducted following the methodology outlined by Arksey and O'Malley methodology. Relevant studies were retrieved from electronic databases (CINAHL, EMBASE, MEDLINE, Global Health, ERIC, and PsycINFO) and grey literature sources, using search terms systematically mapped with the PCC (Population, Context, and Concept) format. The population (P) includes adolescents aged 10-19 years; Context (C) includes Low- and Middle-Income Countries; and Concept (C) includes motherhood and mental health. A two-stage screening process was employed using Covidence software, with conflicts resolved through consensus or consultation with a third reviewer. Data extraction was performed by the primary author and independently reviewed by a second author. The findings were analyzed using descriptive statistics and narrative description. 1240 articles were identified, of which 35 studies met the inclusion criteria. Most studies focused on the postnatal phase, with limited attention to antenatal and childbirth. Mental health issues were the primary focus (88.6%), while some explored factors influencing mental health (57.1%), healthcare access and utilization (8.6%), interventions (2.9%), and coping strategies (8.6%). A majority of studies lacked a specified theoretical framework (85.7%). Most of the studies were from Sub-Saharan Africa. This review provides valuable insights for future research, policy development, and interventions addressing the mental health needs of adolescent mothers in LMICs. It highlights the need for adolescent-responsive mental health policies, integration of mental health services into maternal care, and culturally tailored interventions such as community-based peer support and mobile health tools. Future research should adopt theory-informed, context-specific approaches and expand into underrepresented regions, using qualitative and longitudinal designs to examine the full continuum of motherhood encompassing antenatal, childbirth, and postnatal phases.