Our statistical survey on epidemiological data related to pregnancy loss frequency in Italy and specifically in Lombardy, occurring to young women under 20, was aimed to detect the most important behavioural trends in order to set up the necessary treatments for primary and secondary prevention.

Our statistical survey has been taken from the annual reports provided by Italian Ministry of Health and by the Epidemiological Service of Lombardy Region. It refers to abortions carried out by adolescents under 19 , ranging over years 1985, 1987, 1989, 1991. In this survey ,in particular, rates, recidivism frequency and the registered scholarity among adolescents have been reported.

In this survey , moreover , the characteristics in the recourse the Public Utilities for the issuing of the medical certification have been examined, for the approval of the pregnancy loss , regarding under age people, from the Tutelary Judge and of the period of gestation in which the abortion has been carried out.

The results of this research show , in Lombardy , a decrease of the pregnancy loss rates in adolescence , which decreased from 10.9 in 1985 to 6.5 in 1991 and of recidivism which decreased from 6.4 % to 5.4 % . Nevertheless, the pregnancy loss ratio seems to increase from 604 in 1979 to 1359 abortions against the 1000 children born alive in 1985. The number of high school attending teen-agers , who practised abortion is constantly rising , while a drop from 6.7 % to 4.1 % is registered in young girls who have only the primary school leaving certificates.

With regards to the recourse to social-health service , it has been pointed out , in Lombardy, the appliance to the Family Advice Bureau to get the requested certification on 36% of the cases .

On the other hand , it has been noticed a fall in the appliance to the Tutelary Judge to obtain the assent to abortion of the minors, which passed from 30 % to 22 % . Finally , it has been noticed a request for abortion in the age gestation more advanced, compared with the other age- groups taken under consideration.

Comparing the data of Lombardy with the national ones, the research has pointed out that even if there is an essential analogy decrease of abortion, there are some differences due to higher values in Lombardy regarding to the rates and the abortion ratio.

Statistical data show positive indications in the research of adequate methodologies 100 for primary and secondary prevention of abortion , they indicate specifically :

1) The need of an organic and systematic project for preventive intervention in different institutions (School, Family Consultory, Hospital ).

2) The constant , growing inter-action of the adolescent and his parents with the public services (School and Socio Sanitary Service ); particularly with the Family Consultory during the medical certification to be granted before the abortion .

3) A frequent condition of family and social isolation ("loneliness " is the expression used by some authors : Esposito - Trevisan 1983, Repossi 1992 )

4) The persistence of a frequent utilization of abortion in advanced gestation .

5) The variety of people and services that interact with the adolescent and his family in such an important event for the development of the person , his sexual identity and the relationship parents/children.

The necessity of a specific preparation of the operators envisaging the family problems is also emphasized. Particularly, a specific involving attitude towards decision making in urgent situations as a result of requests for abortion submitted at the twelfth week's limit -as per the Italian Regulations - is also to be cultivated and improved.

Claudio Finicelli: "Pregnancy loss in Adolescence: epidemiological data and treatment guide-lines towards prevention". Paper presented at the First International Congress of Adolescentology, Assisi, Italy, October 22-24 1993.

Key Words: Pregnancy loss, Epidemiological data, Primary and secondary prevention.

Claudio Finicelli: Psicologo coadiutore - Distretto Socio Sanitario, USSL 68 della Lombardia - via Pontida 3 , 20017 RHO (Milano).