Who is having indended births: An analysis of two adolescent birth cohorts (2000-2001 and 2010-2011)

Background. Births to teens are a major public health issue, contributing to poorer outcomes for the infant/child and mother across health, developmental milestones and SES. Not all teen pregnancies are unintended. Understanding this phenomenon can inform public health interventions. Methods. Using birth certificate data we analyzed teen births (ages=<19) from an upstate New York region comparing two birth cohorts: 2000-2001 (n=2252) and 2010-2011 (n=1614). Across the cohorts bivariate analyses described the profile of teens having intended births and compared them to teens with unintended births. Results. Intended births represented 29.9% and 24.8% respectively in the two cohorts and declined by 40% primarily among younger teens (ages 12-15; 2000/01 cohort=8.1%; 2010/11 cohort=1.5%). No significant differences were found among key maternal characteristics but over time normal BMI declined (2000/01 cohort=59.1%; 2010/11 cohort=57.2%) as did first trimester prenatal care initiation (63.8%;59.0%) while smoking during pregnancy (29.9%;35.3%) and medical risk in pregnancy (22.7%;24.3%) increased. Within the cohorts, risk factors associated with intendedness (vs. unintendedness) differed. Teens with intended births from both cohorts were more likely (p<0.05) to be: older, US-born, multiparous; have an STI during pregnancy. Those in the 2000-2001 cohort were additionally significant for: Black, Hispanic, have pre-pregnancy medical risk, inadequate prenatal care and Medicaid as delivery payor. The 2010/2011 teens were additionally significant for non-Black race, smoking during pregnancy and referral for high risk. Conclusions. Intended births among teens declined and their profile changed. Assumptions about this subpopulation need revision. Careful assessment and monitoring of these teens and additional study is warranted.