Maternity in adolescence in Brazil: high fertility rates and stark inequalities across municipalities and regions

Adolescent childbearing is a major public health challenge in Brazil, with a fertility rate of 43.6 births per thousand girls aged 15-19 years in 2022. This study investigated inequalities in adolescent fertility rates (AFR) across Brazilian municipalities, utilizing data from the National Live Births Information System (SINASC) and the 2022 Demographic Census. Analyses included births between 2020 and 2022, excluding municipalities with fewer than 50 births in the 3 years. Municipal AFRs were compared with the average rate in countries classified by income level (high, upper-middle, lower-middle, and low income) and described according to the Brazilian Deprivation Index and population size. Inequalities within each geographic region were assessed using the mean absolute difference to the regional mean and range. Substantial disparities in AFR across regions were found, with the North and Northeast exhibiting the highest estimates, while the South and Southeast showed comparatively lower rates. The Midwest presented intermediate values. We found vast inequalities between municipalities, revealed by graphs and summary measures. A small proportion of municipalities, concentrated in the North region, experience exceptionally high AFR. A strong association between social vulnerability and early childbearing was also identified. Municipalities with higher levels of deprivation had markedly higher AFR, underscoring the influence of broader socio-economic factors on adolescent fertility. The results emphasize the need for targeted interventions and policies that address these underlying contextual determinants to reduce fertility rates among girls in Brazil effectively. Versão em Português: https://doi.org/10.1590/SciELOPreprints.11537