Social disadvantage as a risk for first pregnancy among adolescent females in the United States.
OBJECTIVE
Differences in underlying determinants of pregnancy at different stages of adolescent development have implications for prevention strategies. We sought to determine whether social disparities in rates of adolescent pregnancy vary between early, middle, and late adolescence. We hypothesized that as age increases, racial and socioeconomic disparities in rates of teen conception decrease.


METHODS
Data were obtained from the National Survey of Family Growth cycle 6. Outcome variables indicated whether respondents had a first pregnancy at ages <15 years, 15-17 years, or 18-19 years. Independent variables were race and maternal education level. Logistic regression was used to calculate the relative odds of first conception in a given age range by race and maternal education level.


RESULTS
The disparity in odds of pregnancy between black and white teens is maximal in early adolescence (odds ratios <15 years: 3.9) and decreased by nearly 50% in late adolescence (odds ratios 18-19 years: 2.0, p < .01). After stratifying by maternal education level, the same trends are seen.


CONCLUSIONS
In accordance with our hypothesis, we found that social disparities in pregnancy rates decrease between early and late adolescence. Although pregnancy prevention efforts often target those at social risk including poor minority youth, fewer acknowledge and target the risks associated with development of sexuality in all teens. Efforts to better define the nature of healthy adolescent sexual development may lead to pregnancy prevention interventions focused on developmental risk that can apply to a wider set of adolescents.
Section of Adolescent Medicine, Department of Pediatrics, Georgetown University Medical Center, Washington, DC 20007, USA. krishna.k.upadhya@gunet.georgetown.edu
Krishna K
KK
Upadhya
Jonathan M
JM
Ellen
D000293:Adolescent; D001294:Attitude to Health / Q000208:ethnology*; D044383:Black People / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology*; D012725:Sexual Behavior / Q000208:ethnology; D012931:Social Environment; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*; D001741:Black or African American