Who is Pregnant? Understanding social determinants of health, sexual health, behavioral risk and health outcomes among adolescent girls who have experienced pregnancy

Background: This study examines social determinants of health, sexual health, behavioral risk, and health outcomes among adolescent girls who have experienced pregnancy. Teen pregnancy produces unique and significant challenges for girls living in the United States. Costs associated with teenage pregnancy include economic loss, lower maternal education with subsequent loss of income and economic mobility, worse health outcomes, and social disadvantage. Adverse pregnancy outcomes including low birth weight, preterm birth, and perinatal death are more likely. Methods: Youth Risk Behavior Survey (YRBS) based survey using two-stage cluster sample design in a large urban Midwestern county, resulting in 5,346 participants, with 2827 female, and 213 pregnant girls (7.5%) who are the focus of this analysis. Additional non-YRBS variables include family structure, protective factors, relationship violence, forced sexual contact, sexually transmitted infection, sexual orientation, teen multiparity, and peer and parental disapproval of sex. Results: Teen girls experiencing pregnancy were more likely to be lower SES, minority and have no father in the home. They report fewer protective factors, more permissive parental attitudes, poorer health quality of life, lower academic achievement, higher levels of stress and more depressive symptoms. They are more likely to have experienced sex under the age of 13, relationship violence and forced sexual contact. Unhealthy findings are stronger for teens with two or more pregnancies. Discussion: Girls who have experienced pregnancy report a difficult path through adolescence. Findings support the need for programs to both prevent pregnancy and help those who have experienced pregnancy cope.