Does teen pregnancy foretell subsequent risk of premature death?

Teenage pregnancy has been linked to an increased risk of premature mortality in early adulthood in a recent study.

The population-based cohort study included 2,242,929 teenagers in Ontario, Canada. A total of 163,124 (7.3 percent) became pregnant between 12 and 19 years of age (median age at pregnancy 18 years, interquartile range, 17–19 years).

Of the teen pregnancies, 60,037 (36.8 percent) ended in a birth (99.1 percent live births) and 106,135 (65.1 percent) ended in induced abortion. The median age at the end of follow-up was 25 years for participants without a teen pregnancy (control) and 31 years for those with a teen pregnancy.

There were 6,030 deaths recorded among participants without a teen pregnancy (1.9 per 10,000 person-years), 701 deaths among those without one teen pregnancy (4.1 per 10,000 person-years), and 345 deaths among those with at least two teen pregnancies (6.1 per 10,000 person-years). Compared with control, becoming pregnant in the teenage years was associated with an increased risk of death in early adulthood (one pregnancy: adjusted hazard ratio [aHR], 1.51, 95 percent confidence interval [CI], 1.39–1.63; at least two pregnancies: aHR, 2.14, 95 percent CI, 1.92–2.39).

On further analysis, participants with a teen pregnancy had a consistently heightened risk of death from noninjury (aHR, 1.25, 95 percent CI, 1.12–1.40), from unintentional injury (aHR, 2.06, 95 percent CI, 1.75–2.43), and from intentional injury (aHR, 2.02, 95 percent CI, 1.54–2.65).

Individuals with a history of adverse childhood experiences are also more likely to engage in sexual risk taking and to experience teenage pregnancy, the researchers noted. As such, teen pregnancy may be used to identify some individuals at greater risk of premature mortality and morbidity in early adulthood and facilitate access to appropriate support.