Department of Kinesiology and Health Education, College of Education, University of Texas at Austin, Austin, Texas.
Department of Sociology, College of Liberal Arts, University of Texas at Austin, Austin, Texas.
J Adolesc Health. 2019 Nov;65(5):674-680. doi: 10.1016/j.jadohealth.2019.05.031. Epub 2019 Aug 30.
Approximately 16% of U.S. births to women aged 15-19 years are repeat (second or higher order) births. Repeat teen mothers are at elevated risk for poor perinatal outcomes. Geographic clustering and correlates of repeat teen birth are unknown.
Data from birth certificates on N = 629,939 teen births in N = 3,108 U.S. counties in 2015-2017 were merged with data on county-level demographic, socioeconomic, and health provider characteristics. We identified contiguous clusters of counties with significantly elevated rates of first teen births only, repeat teen births, both, or neither between 2015 and 2017 and compared demographic, socioeconomic, and medical provider characteristics of counties between 2010 and 2016 in each cluster type.
A total of 193 counties (6.21%) had high rates of repeat births only; 504 (16.22%) had high rates of first teen birth only; 991 (31.89%) had high rates of both repeat and first teen births; and 1,420 (45.69%) had neither. Counties with high repeat (vs. first only) birth rates had higher rates of poverty and unemployment, higher levels of income inequality, lower high school graduation rates, a higher share of racial and ethnic minority residents, fewer publicly funded family planning clinics per capita, and more women receiving contraceptive services at publicly funded clinics.
First and repeat teen births cluster in differentially resourced geographic areas. Counties with high repeat teen birth rates have lower socioeconomic conditions than counties with high rates of first teen births only. These counties are more reliant on publicly funded family planning clinics but have fewer of them per capita.
在美国，15-19 岁女性生育的婴儿中，约有 16%是再次生育（第二胎或更高胎次）。再次生育的青少年母亲发生围产期不良结局的风险较高。重复青少年生育的地理聚集性及其相关因素尚不清楚。
将 2015-2017 年在美国 3108 个县的 629939 名青少年生育的出生证明数据与县一级人口统计学、社会经济和医疗服务提供者特征的数据合并。我们确定了连续的县集群，这些县在 2015 年至 2017 年间，只有首次青少年生育、重复青少年生育、两者都有或两者都没有的比率显著升高，并比较了每个集群类型中 2010 年至 2016 年各县的人口统计学、社会经济和医疗服务提供者特征。
共有 193 个县（6.21%）的重复生育率较高；504 个县（16.22%）的首次青少年生育率较高；991 个县（31.89%）的重复和首次青少年生育率均较高；1420 个县（45.69%）两者均无。重复生育率高（而非首次生育率高）的县，贫困率和失业率较高，收入不平等程度较高，高中毕业率较低，少数民族居民比例较高，人均公共资助计划生育诊所较少，在公共资助诊所接受避孕服务的妇女人数较多。
首次生育和重复生育在资源不同的地理区域中聚集。重复生育率高的县比只有首次生育率高的县社会经济条件差。这些县更依赖公共资助的计划生育诊所，但人均诊所数量较少。
