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n=481) and their children (\u226519 months old; n=502) in the Eastern Cape, South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome<\/jats:title>\n                    <jats:p>Optimal well-care visit retention up to 18 months was defined as attending visits within 4\u2009weeks of the recommended child age, attending the 18-month visit and missing no more than one scheduled visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Attendance was highest at the 6-week visit (88.4%; 95% confidence interval (CI) 85.6% to 91.3%) and lowest at the 18-month visit (58.0%, 95% CI 53.6% to 62.3%). About one-third (36.1%; 95% CI 31.8% to 40.3%) of children were retained to 18 months. Retention was highest among children living in rural vs urban areas (adjusted odds ratio (aOR)=2.01, 95% CI 1.32 to 3.06), those born to mothers whose highest education at pregnancy was secondary versus primary school (aOR=2.73, 95% CI 1.60 to 4.65), born via caesarean section vs vaginal birth (aOR=1.65, 95% CI 1.05 to 2.60) and living closer to the clinic (aOR=0.52, 95% CI 0.28 to 0.96 for long vs short distance). There was weak evidence that retention was lower among children of mothers living with HIV (aOR=0.64, 95% CI 0.40 to 1.02) and higher among food-secure children (aOR=2.18, 95% CI 0.96 to 4.96) and those receiving the child support grant (aOR=1.71, 95% CI 0.92 to 3.16).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Universal interventions are needed for retention beyond the neonatal period for children of adolescent mothers living with HIV and HIV-negative adolescent mothers. Interventions must address structural barriers, especially for adolescent mothers with primary education and in urban areas. Future research should examine the underlying mechanisms linking mode of delivery with well-care retention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-106412","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T12:00:29Z","timestamp":1767182429000},"page":"e106412","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Factors Associated with Retention in Routine Well-Care Visits Among Children of Adolescent Mothers Living With and Without HIV: A Community-Based Study in the Eastern Cape, South Africa"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8828-5685","authenticated-orcid":false,"given":"Camille","family":"Wittesaele","sequence":"first","affiliation":[{"name":"International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"Department of Social Policy and Intervention, University of Oxford, Oxford, UK"},{"name":"Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa"},{"name":"Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3800-3173","authenticated-orcid":false,"given":"Elona","family":"Toska","sequence":"additional","affiliation":[{"name":"Department of Social Policy and Intervention, University of Oxford, Oxford, UK"},{"name":"Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie D.","family":"Cluver","sequence":"additional","affiliation":[{"name":"Department of Social Policy and Intervention, University of Oxford, Oxford, UK"},{"name":"Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3547-7936","authenticated-orcid":false,"given":"Helen A.","family":"Weiss","sequence":"additional","affiliation":[{"name":"International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3305-7738","authenticated-orcid":false,"given":"Aoife M.","family":"Doyle","sequence":"additional","affiliation":[{"name":"International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"Biomedical Research and Training Institute, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"2026010703491129000_15.12.e106412.1","doi-asserted-by":"crossref","first-page":"e195","DOI":"10.1016\/S2214-109X(21)00515-5","article-title":"Global, regional, and national trends in under-5 mortality between 1990 and 2019 with scenario-based projections until 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation","volume":"10","author":"Sharrow","year":"2022","journal-title":"Lancet Glob Health"},{"key":"2026010703491129000_15.12.e106412.2","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2017.v108i3b.12812"},{"key":"2026010703491129000_15.12.e106412.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-007681","article-title":"The Effect of Adolescent Pregnancy on Child Mortality in 46 Low- and Middle-Income Countries","volume":"7","author":"Noori","year":"2022","journal-title":"BMJ Glob Health"},{"key":"2026010703491129000_15.12.e106412.4","unstructured":"World Health Organization (WHO), United Nations Children\u2019s Fund (UNICEF) . 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