Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5th Floor, Toronto, Ontario, M5T 3M7, Canada.
Anthropology Department (Health Studies Program), University of Toronto Scarborough, Scarborough, Ontario, Canada.
Arch Womens Ment Health. 2018 Jun;21(3):333-340. doi: 10.1007/s00737-017-0799-5. Epub 2017 Nov 22.
Our objectives were to (1) compare the risks for poor long-term mental health outcomes among indigenous women with and without a teenage pregnancy and (2) determine if community and cultural factors modify this risk. We conducted a secondary analysis of the 2012 Aboriginal Peoples Survey. Respondents were women aged 25 to 49 years who had given birth to at least one child. Teenage mothers (age at first birth 13 to 19 years; n = 1330) were compared to adult mothers (age at first birth 20 years or older; n = 2630). Mental health outcomes were psychological distress, mental health status, suicide ideation/attempt, and alcohol consumption. To address objective 1, we used binary logistic regression analyses before and after controlling for covariates. To address objective 2, we tested the significance of interaction terms between teenage pregnancy status and effect measure modifiers. In unadjusted analyses, teenage pregnancy was associated with increased risk for poor/fair mental health [odds ratio (OR) 1.77, 95% confidence interval (CI) 1.24-2.53] and suicide attempt/ideation (OR 1.95, 95% CI 1.07-3.54). However, the associations were not statistically significant after adjusting for demographic, socioeconomic, environmental, and health covariates. Teenage pregnancy was not associated with increased risk for high psychological distress or heavy alcohol consumption in unadjusted or adjusted analyses. The interaction term for involvement in cultural activities was statistically significant for poor/fair mental health; however, after stratification, ORs were non-significant. Among indigenous mothers, teenage pregnancy was less important than broader social and health circumstances in predicting long-term mental health.
(1) 比较青少年怀孕的土著妇女和没有青少年怀孕的妇女在长期心理健康不良结局方面的风险；(2) 确定社区和文化因素是否会改变这种风险。我们对 2012 年原住民调查进行了二次分析。受访者是年龄在 25 至 49 岁之间、至少生育过一个孩子的妇女。青少年母亲（初育年龄 13 至 19 岁；n=1330）与成年母亲（初育年龄 20 岁或以上；n=2630）进行了比较。心理健康结果包括心理困扰、心理健康状况、自杀意念/尝试和饮酒。为了实现目标 1，我们在控制协变量之前和之后使用了二元逻辑回归分析。为了实现目标 2，我们测试了青少年怀孕状况与效应修正因子之间交互项的显著性。在未调整的分析中，青少年怀孕与较差/一般心理健康（比值比 [OR] 1.77，95%置信区间 [CI] 1.24-2.53）和自杀企图/意念（OR 1.95，95%CI 1.07-3.54）的风险增加相关。然而，在调整了人口统计学、社会经济、环境和健康协变量后，这些关联不再具有统计学意义。在未调整或调整分析中，青少年怀孕与较高的心理困扰或大量饮酒无关。参与文化活动的交互项在较差/一般心理健康方面具有统计学意义；然而，在分层后，OR 无统计学意义。在土著母亲中，青少年怀孕在预测长期心理健康方面不如更广泛的社会和健康环境重要。
