142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Prevalence and Determinants of Teenage Pregnancy in Urban, Disadvantaged Settings Across 5 Cities

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 12:30 PM - 12:40 PM

Anna Kågesten, MPH , Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Baltimore, MD
Mark Emerson , Population, Family and Reproductive Health, Jons Hopkins Bloomberg School of Public Health, Baltimore, MD
Freya Sonenstein, PhD , Center for Adolescent Health, Johns Hopkins University, Baltimore, MD
Sinead Delany-Moretlwe , Wits Reproductive Health and HIV Research, University of Witwatersrand, Johannesburg, South Africa
Heena Brahmbatt, PhD , Department of Population, Family and Reproductive Health, University of Witwatersrand/Johns Hopkins, Baltimore
Objective: To explore individual and neighbourhood characteristics associated with pregnancy among adolescents in urban disadvantaged settings.

Methods: Data were drawn from Phase 2 of the Well Being of Adolescents in Vulnerable Environments study in Baltimore, Johannesburg, Ibadan, Delhi and Shanghai (2013). Respondent-driven sampling (RDS) was used to recruit males and females aged 15-19 for a cross-sectional A-CASI survey; current study N=2,339. Complex survey methods using RDS-II and post-stratification age weights were used to explore bivariate associations with sexual experience and teenage pregnancy; mutivariate models were developed by site and gender with AIC guiding model fit.

Results: Prevalance of teenage pregnancy varied by site and gender; and was most common in Baltimore (females 53%, males 25%) and Jo’burg (females 29%, males 22%). Heterosexual experience and teenage pregnancy was rare in Ibadan, Delhi and Shanghai; multivariate anlaysis in these sites was therefore not possible. Risk-factors for pregnancy among females included: unstable housing and bingedrinking (Baltimore), early sexual debut, greater neighborhood-level fear and violence (Johannesburg); schooling was protective for females in both sites. Among males, adjusted odds of pregnancy increased with bingedrinking, greater neighborhood fear and violence, (Baltimore), early sexual debut and transactional sex (Jo’burg). In both sites, better physcial enviornment decreased the odds or partner ever being pregnant.


Teenage preganancy prevalence varies across disadvantaged urban settings, which could be due to underreported sexual experience. Determinants of teenage pregnancy need to be understood wihtin the specific context that adolescents reside, and particular attention should be paid to the influence of neighborhood-level factors.

Learning Areas:

Public health or related research

Learning Objectives:
Assess the sociodemographic, behavioural and neighbourhood-level factors associated with teenage pregnancy in urban disadvantaged settings

Keyword(s): Adolescents, Reproductive Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student focusing on adolescent reproductive health and epidemiology, and have over 5 years professional experience in developing ASRH interventions both in my native Sweden and internationally. Among my specifics interests are the influence of gender and power imbalances on contraceptive use and pregnancy among urban poor youth. I contributed to the conceptualisation of and conducted all the analyses for the current manuscript.
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.