Women who were pregnant as teenagers are more likely to die before age 31 than those who did not have a teen pregnancy, says Ontario study that calls for more programs to support young people vulnerable and their children.
The study of 2.2 million women aged 12 to 19 showed that the risk of premature death was 1.5 times higher among those who had a teenage pregnancy and 2.1 times higher in those who had at least two teenage pregnancies – the risk being particularly pronounced in adolescents who experienced a pregnancy before the age of 16.
These results are taken from an analysis of anonymized health data for all residents of the province between April 1991 and March 2021. More than 163,000 women in this group became pregnant at a median age of 18, most of them Among them having undergone an induced abortion, and 60,000 having given birth.
The study, published Thursday in JAMA Network Open, shows that teens whose pregnancies ended in induced abortion were at somewhat higher risk of premature death, while the risk was even greater for those who had given birth or has a miscarriage. The study took into account factors such as income, education level and comorbidities.
Young mothers distrust the health system
The DD Ashley Vandermorris, a pediatrician with the Young Families program at the Hospital for Sick Children in Toronto and one of the study’s authors, said teens with two or more pregnancies were twice as likely to die prematurely from various causes. , including induced and unintentional injuries.
The program, which also includes a nurse practitioner, a registered nurse and two social work staff, supports teen mothers and their children until their child’s second birthday.
The team manages all chronic illnesses and provides education on parenting, nutrition, family planning and early childhood literacy, Ms.me Vandermorris, adding that she also connects families to community services that could help with housing and child care.
However, many young mothers are wary of health care providers because of their past experiences, she explained.
We often hear about societal judgments, stigma, and prejudice against these adolescent girls when it comes to their parenting decisions, even though they often demonstrate remarkable resilience.
DD Ashley Vandermorris, pediatrician
Adolescent girls trying to meet the developmental needs of their children while continuing to shape themselves may have grown up in poverty and experienced stressors, including physical, sexual or emotional abuse, domestic violence, substance use and mental illness at home, said Mme Vandermorris.
These early experiences could be strongly associated with unprotected sex, teenage pregnancy and a lower likelihood of completing high school, she added.
However, it is unlikely that young parents would have disclosed these difficulties to a healthcare provider, especially if they have faced stigma and racism in the healthcare system, said Ms.me Vandermorris.
One of the study’s listed limitations is that it did not explore race or ethnicity as contributors to the association between teen pregnancy and early death. The researchers said they did not have a data source for this information and were unaware of why it would be linked to premature death, other than knowing that some racialized groups experience higher rates. higher rates of economic disadvantage and structural racism.
Act on time
One of the study’s key messages is that teenage pregnancy may be an opportunity to identify those most likely to die prematurely and provide them with potentially life-changing supports, including a chance to complete their high school education, she said. They can then move on to community services close to where they live.
However, these services may not be available everywhere, Ms.me Vandermorris.
We strongly advocate for greater access to this type of comprehensive model of care in communities where we know teen pregnancy rates are higher. This type of work is best done within an interdisciplinary team. This is not feasible in a family doctor’s office that operates independently.
DD Ashley Vandermorris, pediatrician
Gillian Thompson, a nurse practitioner with the Young Families Program, said many teenage mothers are reluctant to access services because they fear their children will be removed from their care if they are deemed unfit parents.
“Trauma is a big part, as well as intergenerational trauma. And their experiences with child protection have not always been protective,” she said.
Teen pregnancy rates are steadily declining in Canada due to greater availability of family planning and sexual health services.
Statistics Canada data on fertility rates for people aged 15 to 19, based on live births per 1,000 women, shows the overall rate decreased to 4.4 in 2022, from 6.7 in 2018.
British Columbia reported the lowest fertility rate in this age group, at 2.7 in 2022 compared to 3.7 in 2018. Nunavut had the highest adolescent fertility rate in the country at 67 .2 live births per 1000 women, compared to 101 in 2018.
Quebec had a fertility rate in this age group of 4.2 in 2022, compared to 5.6 in 2018. Ontario’s rate was three, compared to almost five in 2018.
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