King Bryn, Van Wert Melissa
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; Children's Data Network, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California.
Centre for Research on Children and Families, McGill University, Montreal, Quebec, Canada.
J Adolesc Health. 2017 Aug;61(2):226-232. doi: 10.1016/j.jadohealth.2017.02.014. Epub 2017 Apr 21.
Placement into foster care is driven by a number of factors, many of which are associated with adolescent childbirth. Yet, there are few studies that identify the experiences and characteristics that predict adolescent childbirth among girls who spend time in foster care.
A longitudinal, population-based data set was constructed by probabilistically matching California child protective service records for female foster youth to maternal information available on vital birth records for children born between 2001 and 2010. Rates of childbirth among girls in foster care after their 10th birthday were generated. Chi-square tests assessed differences and survival models were specified to determine the rate of childbearing across key characteristics.
Among the 30,339 girls who spent time in foster care as adolescents, 18.3% (5,567) gave birth for the first time before their 20th birthday. At a bivariate level, significant differences (p < .001) in birth rates were observed across demographic characteristics, maltreatment history, and foster care placement experiences. In the fully adjusted survival model, the highest birth rates were observed among girls who entered care between ages 13 and 16 years; had been in care for relatively short periods of time; lived in congregate care at the estimated date of conception; had a history of running away; and were Latina, black, or Native American.
The results suggest that there are identifiable risk factors associated with early childbirth among girls in foster care, which can help determine the timing and location of reproductive health services to minimize unintended pregnancy and maximize adolescent health and well-being.
寄养安置受多种因素驱动，其中许多因素与青少年生育有关。然而，很少有研究能确定在寄养机构生活过的女孩中预测青少年生育的经历和特征。
通过将加利福尼亚儿童保护服务机构关于女性寄养青少年的记录与2001年至2010年出生儿童的重要出生记录中可得的母亲信息进行概率匹配，构建了一个基于人群的纵向数据集。得出了10岁生日后处于寄养状态的女孩的生育比率。采用卡方检验评估差异，并指定生存模型来确定关键特征的生育比率。
在30339名青少年时期在寄养机构生活过的女孩中，18.3%（5567名）在20岁之前首次生育。在双变量层面，观察到不同人口统计学特征、虐待史和寄养安置经历的生育率存在显著差异（p <.001）。在完全调整的生存模型中，13至16岁进入寄养机构的女孩生育率最高；寄养时间相对较短；预计受孕时生活在集体照料机构；有离家出走史；以及拉丁裔、黑人或美洲原住民。
结果表明，寄养女孩早育存在可识别的风险因素，这有助于确定生殖健康服务的时间和地点，以尽量减少意外怀孕并最大限度地提高青少年的健康和福祉。
