Home Medizin Eine Teenagerschwangerschaft kann mit dem Risiko einer vorzeitigen Sterblichkeit im frühen Erwachsenenalter verbunden sein

Eine Teenagerschwangerschaft kann mit dem Risiko einer vorzeitigen Sterblichkeit im frühen Erwachsenenalter verbunden sein

von NFI Redaktion

A recent study published in JAMA Network Open examined the risk of early mortality after age 12 associated with teenage pregnancies and gestational age.

Study: Teenage Pregnancies and Risk of Premature Mortality
Study: Teenage Pregnancies and Risk of Premature Mortality. Image Credit: Pressmaster/Shutterstock.com

Background

Teenage pregnancies are a leading cause of death among young girls in the United States, with direct fatalities mainly attributable to bleeding, high blood pressure, or sepsis.

Adverse childhood experiences (ACEs) such as abuse, family separation, or financial loss are associated with later teenage pregnancies, substance abuse, and suicide.

However, due to small sample sizes, self-reported outcomes, inadequate data on induced abortions, and limited information on causes of death, there is limited research on teenage pregnancies. Population-based statistics from a universal healthcare system in Canada may provide more comprehensive data on teenage pregnancies.

About the Study

In this population-based study, researchers investigated the risk of premature death at age 12 associated with teenage pregnancies.

The study was conducted in Ontario between April 1, 1991, and March 31, 2022, involving women aged 12 with coverage under the Ontario Health Insurance Plan (OHIP).

The primary exposure was the count of teenage pregnancies ages 12 to 19, categorized as live births, stillbirths, induced abortions, or miscarriages among teenagers. Secondary study exposures included teenage pregnancy outcomes (miscarriage or delivery vs. induced abortions) and the participants‘ age at their first teenage pregnancy.

The primary endpoint was death from any cause starting at age 12, while the secondary study outcome was death from any cause starting at age 20.

Records, including hospitalizations, emergency room visits, census data, births, deaths, and induced abortions, were analyzed at ICES using unique coded identifiers and deterministically linked.

The team used Cox Proportional-Hazards regressions to calculate adjusted hazard ratios (AHRs), including covariates such as birth year, comorbid conditions between ages 9 and 11, rurality, regional education level, and income.

For intentionally fatal injuries in individuals with or without teenage pregnancies, they provided a breakdown of injuries related to assault and self-harm using ICD codes 9 and 10.

Results

Of the 2,242,929 individuals, 7.3% (n=163,124) had a teenage pregnancy by age 18 (median), with 121,276 (74%) reporting one pregnancy and 41,848 (26%) reporting two or more pregnancies.

Individuals with teenage pregnancies were more likely to reside in the lowest income quintile and areas with lower high school graduation rates.

Women with teenage pregnancies had a higher percentage of self-harm during ages 12 to 19 [5.0% (n=8,123) vs. 1.5% (n=30,669)] but no comorbid conditions, including those related to mental or physical health.

Of those with teenage pregnancies, 37% (n=60,037) gave birth [including 99% (n=59,485) live births], 65% (n=106,135) had abortions, and 11% (n=17,945) had miscarriages or ectopic pregnancies.

The mean participant age after follow-up was 25 years for women without teenage pregnancies and 31 years for participants with teenage pregnancies.

Comparing those without teenage pregnancy history, the adjusted hazard ratios for premature mortality were 1.4 for the first teenage pregnancy resulting in termination and 2.1 for pregnancies leading to delivery or miscarriage.

For individuals with and without teenage pregnancy history, the adjusted hazard ratios for premature mortality due to non-injury, unintentional harm, and intentional harm were 1.3, 2.1, and 2.0 respectively.

Non-injury related premature mortality was more common in individuals with teenage pregnancies (2.0 per 10,000 person-years) than unintentional (1.0 per 10,000 person-years) or intentional (0.4 per 10,000 person-years) injury-related deaths.

Those who had a teenage pregnancy before age 16 had the highest premature mortality rate with an AHR of 2.0.

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