Manlove J, Terry E, Gitelson L, Papillo A R, Russell S
Child Trends, Washington, DC, USA.
Fam Plann Perspect. 2000 Jul-Aug;32(4):166-75.
The teenage birthrate rose sharply in the late 1980s and early 1990s, and then declined in the 1990s. Attempts to explain these changes have failed to account for the changing environment in which adolescents live.
Data from the 1995 cycle of the National Survey of Family Growth are used to compare the experiences of three cohorts of teenage females in the 1980s and 1990s. A life-course framework is used to examine trends in characteristics of adolescents and adolescent mothers over time, and event-history analyses are conducted to determine which characteristics are associated with the risk of a teenage birth in each cohort. A comparison of the predicted probabilities from hazard analyses shows how changes in the context of adolescence across the cohorts help explain changes in the probability of a teenage birth over time.
Factors associated with the increase in the teenage birthrate in the 1980s include negative changes in family environments (such as increases in family disruption) and an increase in the proportion of teenagers having sex at an early age. Factors associated with the recent decline in the teenage birthrate include positive changes in family environments (such as improvements in maternal education), formal sex education programs and discussions with parents about sex, stabilization in the proportion of teenagers having sex at an early age and improved contraceptive use at first sex. Sexually experienced teenagers in the mid- 1990s were younger, on average, at first sex than were their counterparts in the 1980s, and thus are at an increased risk of a teenage birth. Partner factors, including nonvoluntary first sexual experiences, were not associated with the risk of a adolescent birth in any cohort.
Programs to further reduce the teenage birthrate should take into account the role of family stability, parent-child communication, sex education programs and engagement in school, as well as attempt to reduce the proportion of adolescents having sex at an early age and to improve contraceptive use. The increasing risk levels among sexually experienced teenagers suggest that current programs may be reducing sexual activity among adolescents already at a low risk of a teenage birth, without addressing the needs of those at highest risk.
青少年生育率在20世纪80年代末和90年代初急剧上升,然后在90年代下降。试图解释这些变化的研究未能考虑到青少年生活环境的变化。
利用1995年全国家庭成长调查的数据,比较了20世纪80年代和90年代三个青少年女性队列的经历。采用生命历程框架来研究青少年及青少年母亲的特征随时间的变化趋势,并进行事件史分析以确定每个队列中哪些特征与青少年生育风险相关。通过对风险分析预测概率的比较,展示了不同队列中青少年环境的变化如何有助于解释青少年生育率随时间的变化。
与20世纪80年代青少年生育率上升相关的因素包括家庭环境的负面变化(如家庭破裂增加)以及过早发生性行为的青少年比例上升。与近期青少年生育率下降相关的因素包括家庭环境的积极变化(如母亲教育水平提高)、正规性教育项目以及与父母关于性的讨论、过早发生性行为的青少年比例稳定以及首次性行为时避孕措施使用的改善。20世纪90年代中期有性经历的青少年首次性行为的平均年龄比80年代的同龄人更小,因此青少年生育风险增加。伴侣因素,包括非自愿首次性经历,在任何队列中都与青少年生育风险无关。
进一步降低青少年生育率的项目应考虑家庭稳定、亲子沟通、性教育项目及学校参与的作用,同时努力降低过早发生性行为的青少年比例并改善避孕措施的使用。有性经历青少年中风险水平的增加表明,当前项目可能在减少已经处于低青少年生育风险的青少年的性活动,而未满足最高风险人群的需求。