185541 Association of acculturation and parental education with teenage childbearing among Latina women in California

Tuesday, October 28, 2008

Christine E. Dehlendorf, MD , Family and Community Medicine, University of California, San Francisco, San Francisco, CA
Kristen Marchi, MPH , Family and Community Medicine, University of California, San Francisco, San Francisco, CA
Eric Vittinghoff, PhD , Epidemiology and Biostatistics, UCSF, San Francisco, CA
Paula A. Braveman, MD, MPH , Family and Community Medicine, University of California, San Francisco, San Francisco, CA
Background: Births to adolescent mothers are associated with adverse outcomes, including pregnancy complications, decreased educational attainment and increased rates of subsequent poverty for the mother and increased risk of neglect, behavioral problems and low educational achievement for the child. U.S Latinas have a persistently high rate of teenage childbearing, with a rate of 81 per 1,000, compared to 26 per 1,000 among non-Latina Whites (hereafter "Whites"). While one commonly mentioned hypothesis is that less acculturated teens have higher levels of teen childbearing because they are more affected by value systems from their countries of origin which value early fertility, the role of acculturation with teenage childbearing in this population is not well understood. In addition, while lower levels of parental education, as a marker of childhood socioeconomic status, has been associated with earlier onset of sexual activity and teen pregnancy among Whites and Blacks, this has not been well studied among Latinas. Methods: Logistic regression was used to analyze the association of measures of acculturation and parental education with age at first birth in a population-based sample of post-partum primiparous women in California. Additional analyses estimated the percentage of Latinas' excess odds (vs Whites) of teen childbearing associated with differences in acculturation and parental education. Results: The unadjusted odds of teenage birth for Latinas compared to Whites was 5.2 (95% CI 4.1-6.6). Speaking Spanish, but not birthplace, was significantly associated with teen birth (p=0.001 and p=0.62). Non-US born Latinas had a 7% (95% CI 1%-12%)decreased odds of teen birth for every year they lived outside the United States. A significant interaction between race/ethnicity and parental education was identified (p=0.001). Parental education was significantly associated with the odds of teen birth among both Whites (p=0.001) and Latinas (p=0.01) Acculturation measures accounted for 17% (95% CI 8-29%) and parental education accounted for 25% (95% CI 9-46%) of the Latina-White disparity in teenage childbirth. Discussion: These findings call into question assumptions about the relationship of acculturation with teen fertility, with no effect of nativity and a decreased odds of teen birth associated with coming to the US later in life. While the effect of language observed in our sample can be interpreted as consistent with a protective effect of acculturation, it may also be related to access to care or other societal factors unrelated to norms from the country of origin. Consistent with findings about non-Latina Whites and Blacks, the results suggest that improving childhood socioeconomic factors among Latinas may significantly decrease teen childbearing in this population and improve the well-being of subsequent generations.

Learning Objectives:
1. Describe the relationship between measures of acculturation and the odds of teenage birth among primiparous Latinas in California. 2. Describe the relationship betewen parental education and teenage birth among primiparous Latinas in California. 3. Articulate policy implications for lowering the rate of teenage births among Latinas in California.

Keywords: Reproductive Health, Latinas

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a family planning fellow in the process of obtaining a Master's degree in Clinical Research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.