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Teenage Pregnancy

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Teenage Pregnancy, Teen Pregnancy, Adolescent Pregnancy, Teen Mother

  • Epidemiology
  1. United States Teen Pregnancy rates have been decreasing for decades, but still remain high, especially among non-white cohorts
    1. Incidence: 158,000 teenage pregnancies (4%) of a total of 3.6 Million U.S. live births in 2020
    2. Contrast with 365,000 teenage pregnancies (9%) of 4 Million U.S. live births in 2010
    3. Non-White or hispanic Teenage Pregnancy rate is twice non-hispanic white rate
  2. U.S. Teen Birth Rate: 15.4 per 1,000 females age 15 to 18 years (2020)
    1. Decreasing from peak of 96 per1000 in 1957 (was 60 in 1990, 17.4 per 1000 females in 2018)
    2. However, rates vary widely throughout the country (from 6.1 in Massachusetts to 27.9 in Mississippi)
  3. Teen sexual intercourse Incidence has decreased and Contraception use has increased since the 1980s
    1. Between 2011 and 2015, of 15-17-year-olds, 31% of boys and 28% of girls had sexual intercourse.
    2. Contrast with 1988 when 60% of boys and 51% of girls reported sexual activity
    3. Up to 98% of girls reported Condom use
  1. Majority of teenage pregnancies are unplanned
  2. Inconsistent Condom usage
    1. First intercourse: 50% of teenagers use Condoms
    2. Most recent intercourse: 78% Condom usage
  3. Teens conceive on OCP twice as often as adults
  4. Teens have poorer Maternal and Baby Health Outcomes
    1. Later Prenatal Care
    2. Poor nutrition
    3. Other lifestyle
  • Complications
  • Maternal
  1. Late onset of Prenatal Care
  2. Hypertensive Disorders of Pregnancy
  3. Anemia
  4. Poor maternal weight gain
  5. Sexually Transmitted Infection
  6. Substance Abuse in Pregnancy
  7. Depression in Pregnancy and Postpartum Depression
  8. Operative delivery
  9. Intimate Partner Violence
  10. Socioeconomic adverse effects (esp. in the 20% with recurrent Teen Pregnancy)
    1. Decreased maternal level of education reached (50% will not complete high school by age 22, compared with 90% if nonpregnant)
    2. Financial dependence (including government support)
  • Complications
  • Newborn
  1. Preterm delivery
  2. Low birthweight infant
  3. Childhood behavioral disorder
  4. Increased infant mortality
  • Management
  1. Provide easy access to perinatal care
  2. Repeatedly screen for high risk conditions
    1. Substance Abuse in Pregnancy
    2. Intimate Partner Violence
    3. Sexually Transmitted Infection (and expedited partner therapy)
    4. Depression in Pregnancy and Postpartum Depression (as well as other Mood Disorders)
    5. Anemia and other nutritional deficiency
    6. Hypertensive Disorders of Pregnancy
    7. Food insecurity
    8. Homelessness
  3. Expand support network
    1. Involve social workers and case managers
    2. Involve nutritionists as needed
    3. Family Home Visiting referral (e.g. NFP, HFA, MECSH) via local public health
    4. Doula
  4. Provide counseling regarding pregnancy options (termination, adoption, parenting)
  5. Schedule appointments and prenatal classes that allow patient to continue education and work
  6. Allow for drop-in availability for nurse visits and Telemedicine
  7. Coordinate postpartum visits with Well Child Visits
  8. Encourage Breast Feeding (facilitate Breast Pumps and other support)
  9. Ensure reliable Contraception after delivery (e.g. IUD, Contraceptive Implant)
  • Resources
  1. Teen Pregnancy (CDC)
    1. https://www.cdc.gov/teenpregnancy/about/index.htm
  • References
  1. Dakkak (2022) Am Fam Physician 106(6): 608-11 [PubMed]