1. In this cohort study of female teenagers in Ontario, Canada, the risk of premature death was greater among females with one teen pregnancy, and even greater among those who experienced two or more teen pregnancies.

Evidence Rating Level: 2 (Good)

Deaths during teen pregnancy and childbirth, including those due to hemorrhage, hypertensive disorders, or sepsis, are rare events. However, researchers postulated that teen pregnancy may be a marker of adverse childhood experiences (ACEs) before or during formative teenage years, which may increase the risk for premature mortality. This cohort study included 2,242,929 females alive at age 12 between 1991 and 2021 in Ontario, Canada. Among this cohort, 7.3% experienced a teen pregnancy at a median age of 18 years. The median age at follow-up was 25 years for those without a teen pregnancy and 31 years for those with a teen pregnancy. Among those with a teen pregnancy, 36.8% ended in a live birth, while 65.1% ended in an induced abortion. Among those without a teen pregnancy, death occurred at 1.9 per 10,000 person-years (95% CI, 1.9-2.0 per 10,000 person-years), among those with one teen pregnancy, death occurred at 4.1 per 10,000 person-years (95% CI, 3.8-4.5 per 10 000 person-years), and among those with two or more teen pregnancies, death occurred at 6.1 per 10 000 person-years (95% CI, 5.5-6.8 per 10 000 person-years). Compared to 0 pregnancies, the risk of of premature death was greater for those with one pregnancy, (adjusted HR [AHR], 1.51; 95% CI, 1.39-1.63), and those with two or more pregnancies (AHR, 2.14; 95% CI, 1.92-2.39). This study may have implications for clinical practice and policy-making, indicating that a teen pregnancy may be an important time point for identifying individuals who would benefit from increased social support. Overall, this study demonstrates that the risk of premature death is greater among females with one teen pregnancy, and even greater among those with two or more teen pregnancies. 

Click to read the study in JAMA Network Open

Image: PD

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