title: Association of early childbearing and low cognitive ability.
abstract: BACKGROUND
  Teenage pregnancy remains a pressing social issue and public health problem in the United States. Low cognitive ability is seldom studied as a risk factor for adolescent childbearing.
  
  
  METHODS
  Data from the National Longitudinal Survey of Youth were used in a matched-pairs nested case-control study comparing women who had a first birth before age 18 with those who did not. Significant differences in Armed Forces Qualifications Test scores and in reproductive and social intervening variables were determined using chi-square analyses and t-tests. Multiple logistic regression models determined the independent effects of specific factors on early childbearing.
  
  
  RESULTS
  Women who had their first birth before age 18 had significantly lower cognitive scores than others; women with a second birth before age 20 had significantly lower scores than those with one teenage birth. On average, women with the lowest cognitive scores initiated sexual activity 1.4 years earlier than those with the highest cognitive scores. Among those who had had a sexuality education course, a smaller proportion of women had scores in the first quartile for the overall sample than in the fourth quartile (20% vs. 28%); an even greater difference was seen among women who correctly answered a question about pregnancy risk (14% vs. 43%). Both poverty and low cognitive ability increased the odds of early childbearing.
  
  
  CONCLUSIONS
  Young women with low cognitive ability are at increased risk for early initiation of sexual activity and early pregnancy. Further research is needed to design interventions that consider this population's specific information and support needs.
authors.affiliation: Civitan International Research Center, University of Alabama at Birmingham, USA. dshearer@hsc.usf.edu
authors.forename: Darlene L
authors.initials: DL
authors.lastname: Shearer
authors.forename: Beverly A
authors.initials: BA
authors.lastname: Mulvihill
authors.forename: Lorraine V
authors.initials: LV
authors.lastname: Klerman
authors.forename: Jan L
authors.initials: JL
authors.lastname: Wallander
authors.forename: Mary E
authors.initials: ME
authors.lastname: Hovinga
authors.forename: David T
authors.initials: DT
authors.lastname: Redden
mesh_terms: D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008423:Maternal Age; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000523:psychology / Q000706:statistics & numerical data*; D012307:Risk Factors; D012725:Sexual Behavior; D014481:United States / Q000453:epidemiology