Determinasi Sosial Kesehatan dan Pengaruhnya pada Reproduksi Remaja serta Risiko PCOS: Suatu Kajian Sistematik

Abstract

Adolescent reproductive health is a global strategic issue influenced by the Social Determinants of Health (SDoH). Socioeconomic disparities, education, psychosocial stress, and limited access to healthcare play a crucial role in increasing the risk of hormonal disorders such as Polycystic Ovary Syndrome (PCOS). This systematic review aims to synthesize recent empirical evidence (2020–2025) on the influence of SDoH on adolescent girls' reproductive health and PCOS risk. The study applied a systematic review design following the PRISMA 2020 guidelines, with literature searches conducted across five major databases (Scopus, PubMed, ScienceDirect, SpringerLink, and Wiley Online Library). A total of 65 articles met the inclusion criteria and were analyzed using a narrative–thematic approach based on the WHO SDoH framework (2021) and the Social Ecological Model (Bronfenbrenner). The findings indicate that social factors such as economic status, education, and family support significantly affect adolescent reproductive health, while chronic stress and food insecurity act as biological mediators through HPA axis activation and insulin resistance. Limited access to healthcare services further delays early diagnosis and prevention of PCOS. It is concluded that PCOS represents a complex socio-biological interaction, highlighting the need for preventive efforts that integrate social, educational, and gender-equitable policy approaches.