Section of Adolescent Medicine, Department of Pediatrics, Georgetown University Medical Center, Washington, DC 20007, USA.
J Adolesc Health. 2011 Nov;49(5):538-41. doi: 10.1016/j.jadohealth.2011.04.011. Epub 2011 Jun 8.
Differences in underlying determinants of pregnancy at different stages of adolescent development have implications for prevention strategies. We sought to determine whether social disparities in rates of adolescent pregnancy vary between early, middle, and late adolescence. We hypothesized that as age increases, racial and socioeconomic disparities in rates of teen conception decrease.
Data were obtained from the National Survey of Family Growth cycle 6. Outcome variables indicated whether respondents had a first pregnancy at ages <15 years, 15-17 years, or 18-19 years. Independent variables were race and maternal education level. Logistic regression was used to calculate the relative odds of first conception in a given age range by race and maternal education level.
The disparity in odds of pregnancy between black and white teens is maximal in early adolescence (odds ratios <15 years: 3.9) and decreased by nearly 50% in late adolescence (odds ratios 18-19 years: 2.0, p < .01). After stratifying by maternal education level, the same trends are seen.
In accordance with our hypothesis, we found that social disparities in pregnancy rates decrease between early and late adolescence. Although pregnancy prevention efforts often target those at social risk including poor minority youth, fewer acknowledge and target the risks associated with development of sexuality in all teens. Efforts to better define the nature of healthy adolescent sexual development may lead to pregnancy prevention interventions focused on developmental risk that can apply to a wider set of adolescents.
青少年发育不同阶段妊娠的潜在决定因素存在差异,这对预防策略具有重要意义。我们旨在确定青少年妊娠率的社会差异在青少年早期、中期和晚期是否存在差异。我们假设,随着年龄的增长,青少年怀孕率的种族和社会经济差异会减少。
数据来自国家家庭增长调查周期 6。因变量表示受访者在 15 岁以下、15-17 岁或 18-19 岁时是否有过第一次妊娠。自变量为种族和母亲的教育水平。使用逻辑回归计算在特定年龄范围内按种族和母亲教育水平计算的首次妊娠的相对几率。
黑人青少年和白人青少年妊娠几率的差异在青少年早期最大(<15 岁的比值比:3.9),在青少年晚期下降近 50%(18-19 岁的比值比:2.0,p <.01)。按母亲教育水平分层后,也存在同样的趋势。
根据我们的假设,我们发现妊娠率的社会差异在青少年早期和晚期之间有所减少。尽管妊娠预防工作通常针对包括贫困少数族裔青年在内的处于社会风险中的人群,但很少有人认识到并针对所有青少年在发展性方面的相关风险。努力更好地定义健康青少年性发展的性质,可能会导致专注于发展风险的妊娠预防干预措施,这些措施适用于更广泛的青少年群体。