title: Availability of Reproductive Health Care Services at Schools and Subsequent Birth Outcomes Among Adolescent Mothers.
abstract: Adverse birth outcomes are more common among adolescent versus adult mothers, but little is known about school-based services that may improve birth outcomes in this group.
  
  
  
  Data from Waves I and IV of the National Longitudinal Study of Adolescent Health were analyzed. Girls and women who gave birth to singleton live infants after Wave I and before age 20, were still in secondary school while pregnant, and had complete data (N = 402) were included. Mothers reported infants' birthweight and gestational age. School administrators reported whether family planning counseling, diagnostic screening (including sexually transmitted diseases [STDs]), STD treatment, and prenatal/postpartum health care were provided on-site at school at Wave I. Multilevel models adjusted for individual and school characteristics were conducted.
  
  
  
  Few schools offered reproductive health care services on-site. In multilevel analyses, availability of family planning counseling (Est. β = 0.21, 95% confidence interval [CI] 0.04-0.38 p < 0.05) and prenatal/postpartum health care (Est. β = 0.21, 95% CI 0.02-0.40 p < 0.05) were significantly associated with increased infant birthweight. No services examined were significantly associated with increased gestational age.
  
  
  
  Some school-based reproductive health services may improve subsequent birth outcomes among adolescent mothers. Future analyses should examine the mechanisms by which services impact birth outcomes.
authors.affiliation: Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112. aspriggs@tulane.edu.
authors.forename: Aubrey S
authors.initials: AS
authors.lastname: Madkour
authors.affiliation: Payer and Provider Research, HealthCore, Inc., 123 Justison Street, Suite 200, Wilmington, DE 19801. yxie@healthcore.com.
authors.forename: Yiqiong
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2000, New Orleans, LA 70112. eharvill@tulane.edu.
authors.forename: Emily W
authors.initials: EW
authors.lastname: Harville
mesh_terms: D000293:Adolescent; D001724:Birth Weight; D005193:Family Planning Services / Q000458:organization & administration; D005260:Female; D005865:Gestational Age; D006801:Humans; D008137:Longitudinal Studies; D008427:Maternal Health Services / Q000458:organization & administration*; D011181:Postnatal Care / Q000458:organization & administration; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011253:Pregnancy in Adolescence; D011295:Prenatal Care / Q000458:organization & administration; D034121:Reproductive Health Services / Q000458:organization & administration*; D012572:School Health Services / Q000458:organization & administration*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis; D055815:Young Adult
keywords: adolescent pregnancy; birth outcomes; multilevel analysis; school health services