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 Nearly 36 percent of girls who first got pregnant
before age 15 had sex for the first time with a partner at least six
years older, compared to 17 percent of girls who got pregnant
between 15 and 19.
That statistic "is very serious and represents complicated
relationships with unequal power," said lead author and obstetrician
Dr. Marcela Smid, from the University of North Carolina at Chapel
Hill. She worked on the study while at the University of Chicago.
To make better use of public health awareness and intervention
campaigns, Smid and her team wanted to know more about how very
young teens were at risk of becoming pregnant.
They used data from the National Survey of Family Growth collected
between 2006 and 2010. A total of 3,384 women reported on the survey
that they had their first pregnancy before age 20. Within that
group, 289 women had become pregnant before age 15 and the rest
between 15 and 19.
Girls who became pregnant before age 15 were twice as likely as
older girls to be Hispanic or black, the researchers found.
Younger pregnant teens were less likely to have been living with
both biological parents at age 14 and less likely to have been
brought up within the Catholic or Protestant religions.
Only 25 percent of the youngest teen group reported using
contraceptives the first time they had sex, compared to 56 percent
of older girls.
While it is "a little bit easier to study live births with national
survey and surveillance data," those statistics don't tell the
complex story of pregnancies, Smid said.
Many pregnancies among very young girls end in miscarriage or
abortion, she noted.
"We know that their risk of poor pregnancy outcomes is the highest
of any age group, even when compared with women who get pregnant at
age 45," Smid said.
In general, U.S. teen pregnancy rates have gradually declined, but,
for the youngest teens especially, "any pregnancy rate above zero is
too high," she said.
About one in 1,000 girls under the age of 15 became pregnant in
2008, the researchers write in the journal Obstetrics and
Gynecology. That compares with about 68 per 1,000 girls between ages
15 and 19.
The researchers also found that 89 percent of the under-15 group did
not want to become pregnant in the first place, compared with 75
percent of teens between ages 15 and 19.
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"There are still things we don't know," Smid said.
"For example, we looked at the first sex experience, but we don't
know the circumstance or the partner involved in the first
pregnancy."
"Measuring pregnancy intention is an extremely complicated thing to
do," said Phillip Levine, an economist at Wellesley College in
Massachusetts who has studied teen pregnancy. "Asking
someone years after the fact what was going on in their minds during
the act — that's difficult to untangle," he said.
Women in the new study were in their early 30s, on average, when
asked about past pregnancies.
Levine also noted that for some girls, tough economic and family
situations mean there's not much of an incentive to avoid early
pregnancies.
"What we need to consider to fix the problem is think about how
these disadvantages contribute to teens becoming pregnant," Levine,
was not involved in the current study, told Reuters Health.
"Teens must want to avoid getting pregnant, or else it doesn't
matter what the intervention is," whether sex education or better
contraceptive access.
If young girls are already on a path that does not include college
or a job that leads to a change in socioeconomic status, then having
a baby may not seem like such a bad idea, he explained.
"A lot of the problem is about opportunity," Levine said.
"We live in a society where income inequality is large and growing,"
he said. "Teen pregnancy can be seen as a symptom of this broader
problem. We need to find ways to allow people to be upwardly
mobile." ___
Source: http://bit.ly/1eXPm0Y
Obstetrics & Gynecology, online Feb. 4, 2014.
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