McCall Stephen J, Bhattacharya Sohinee, Okpo Emmanuel, Macfarlane Gary J
Epidemiology Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.
Department of Public Health, National Health Service (NHS) Grampian, Aberdeen, UK.
J Epidemiol Community Health. 2015 Jan;69(1):49-54. doi: 10.1136/jech-2014-204214. Epub 2014 Sep 16.
Teenage pregnancy is a known social problem which has been previously described using a number of deprivation measures. This study aimed to explore the temporal patterns of teenage pregnancy in Aberdeen, Scotland and to assess the discriminating ability of three measures of socioeconomic status.
This was a population-based study from 1950 to 2010, using data from the Aberdeen Maternity Neonatal Databank (AMND). The main outcome variable was conceptions occurring in women aged less than 20 years. This study used two area-based measures, the Scottish Index of Multiple Deprivation (SIMD) and the Carstairs index, and one individual-based measure the Social Class based on Occupation (SCO). These measures were compared for their association with teenage conceptions using logistic regression models. The models were used to determine receiver operating characteristic (ROC) curves showing the discriminating ability of the measures.
There was an overall decline in teenage conceptions over the 60-year period, but an increase in the rate ratio for deprived areas. All the measures of socioeconomic status were highly associated with teenage pregnancy. The adjusted OR of SIMD and teenage conception was 5.72 (95% CI 4.62 to 7.09), which compared the most deprived decile with the least deprived decile. The use of ROC curves showed that socioeconomic measures performed better than chance at determining teenage conceptions (χ(2)=21.67, p≤0.0001). They further showed that the SIMD had the largest area under the curve (AUC) with a value of 0.81 (95% CI 0.80 to 0.82), followed by the Carstairs index with an AUC of 0.80 (95% CI 0.78 to 0.80), then by SCO with an AUC of 0.79 (95% CI 0.78 to 0.80).
Despite a slight decline in teenage pregnancies over the past decades, there is still an evident association between deprivation and teenage pregnancy. This study shows that all the measures of socioeconomic status were highly associated with teenage pregnancy, with the SIMD having the greatest discriminatory effect.
青少年怀孕是一个众所周知的社会问题，此前已使用多种贫困衡量标准进行过描述。本研究旨在探讨苏格兰阿伯丁青少年怀孕的时间模式，并评估三种社会经济地位衡量标准的区分能力。
这是一项基于1950年至2010年阿伯丁产妇新生儿数据库（AMND）数据的人群研究。主要结局变量是20岁以下女性的怀孕情况。本研究使用了两种基于地区的衡量标准，即苏格兰多重贫困指数（SIMD）和卡斯泰尔斯指数，以及一种基于个人的衡量标准，即职业社会阶层（SCO）。使用逻辑回归模型比较这些衡量标准与青少年怀孕的关联。这些模型用于确定显示衡量标准区分能力的受试者工作特征（ROC）曲线。
在60年期间，青少年怀孕总体呈下降趋势，但贫困地区的比率有所上升。所有社会经济地位衡量标准都与青少年怀孕高度相关。SIMD与青少年怀孕的调整后比值比为5.72（95%置信区间4.62至7.09），比较了最贫困十分位数与最不贫困十分位数。ROC曲线的使用表明，社会经济衡量标准在确定青少年怀孕方面的表现优于随机水平（χ²=21.67，p≤0.0001）。它们进一步表明，SIMD的曲线下面积（AUC）最大，值为0.81（95%置信区间0.80至0.82），其次是卡斯泰尔斯指数，AUC为0.80（95%置信区间0.78至0.80），然后是SCO，AUC为0.79（95%置信区间0.78至0.80）。
尽管在过去几十年中青少年怀孕略有下降，但贫困与青少年怀孕之间仍存在明显关联。本研究表明，所有社会经济地位衡量标准都与青少年怀孕高度相关，其中SIMD的区分效果最大。
