title: Evaluating the social determinants of teenage pregnancy: a temporal analysis using a UK obstetric database from 1950 to 2010.
abstract: BACKGROUND
  Teenage pregnancy is a known social problem which has been previously described using a number of deprivation measures. This study aimed to explore the temporal patterns of teenage pregnancy in Aberdeen, Scotland and to assess the discriminating ability of three measures of socioeconomic status.
  
  
  METHODS
  This was a population-based study from 1950 to 2010, using data from the Aberdeen Maternity Neonatal Databank (AMND). The main outcome variable was conceptions occurring in women aged less than 20 years. This study used two area-based measures, the Scottish Index of Multiple Deprivation (SIMD) and the Carstairs index, and one individual-based measure the Social Class based on Occupation (SCO). These measures were compared for their association with teenage conceptions using logistic regression models. The models were used to determine receiver operating characteristic (ROC) curves showing the discriminating ability of the measures.
  
  
  RESULTS
  There was an overall decline in teenage conceptions over the 60-year period, but an increase in the rate ratio for deprived areas. All the measures of socioeconomic status were highly associated with teenage pregnancy. The adjusted OR of SIMD and teenage conception was 5.72 (95% CI 4.62 to 7.09), which compared the most deprived decile with the least deprived decile. The use of ROC curves showed that socioeconomic measures performed better than chance at determining teenage conceptions (χ(2)=21.67, p≤0.0001). They further showed that the SIMD had the largest area under the curve (AUC) with a value of 0.81 (95% CI 0.80 to 0.82), followed by the Carstairs index with an AUC of 0.80 (95% CI 0.78 to 0.80), then by SCO with an AUC of 0.79 (95% CI 0.78 to 0.80).
  
  
  CONCLUSIONS
  Despite a slight decline in teenage pregnancies over the past decades, there is still an evident association between deprivation and teenage pregnancy. This study shows that all the measures of socioeconomic status were highly associated with teenage pregnancy, with the SIMD having the greatest discriminatory effect.
authors.affiliation: Epidemiology Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: McCall
authors.affiliation: Epidemiology Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.
authors.forename: Sohinee
authors.initials: S
authors.lastname: Bhattacharya
authors.affiliation: Department of Public Health, National Health Service (NHS) Grampian, Aberdeen, UK.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Okpo
authors.affiliation: Epidemiology Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Macfarlane
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D016015:Logistic Models; D017533:Marital Status; D015999:Multivariate Analysis; D016012:Poisson Distribution; D011204:Poverty Areas; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D012372:ROC Curve; D012042:Registries; D012606:Scotland / Q000453:epidemiology; D012923:Social Class
keywords: REPRODUCTIVE HEALTH; SEXUAL HEALTH; SOCIO-ECONOMIC