Maternal and Child Health Program, Department of Family Science, University of Maryland School of Public Health, College Park, Maryland.
Maternal and Child Health Program, Department of Family Science, University of Maryland School of Public Health, College Park, Maryland.
J Adolesc Health. 2020 Aug;67(2):239-244. doi: 10.1016/j.jadohealth.2020.02.001. Epub 2020 Apr 5.
This study aimed to examine whether the timing of depression onset relative to age at sexual debut is associated with teenage pregnancy.
Using data from 1,025 adolescent girls who reported having had sex in the National Comorbidity Survey-Adolescent Supplement, we applied cox proportional hazards models to test whether depression onset before first sex, at the same age as first sex, or after first sex compared with no depression onset was associated with experiencing a first teenage pregnancy. We examined the unadjusted risk by depression status as well as risk adjusted for adolescents' race/ethnicity, marital status, poverty level, whether the adolescent lived in a metropolitan area, living status, age at first sex, parental education, and age of mother when the adolescent was born.
In both unadjusted and adjusted models, we found that adolescents with depression onset at the same age as having initiated sex were at an increased risk of experiencing a teenage pregnancy (unadjusted hazard ratio [HR] = 2.5, 95% confidence interval [CI]: 1.08-5.96; adjusted HR = 2.7, 95% CI: 1.15-6.34) compared with those with no depression onset. Moreover, compared with those with no depression onset, the risk of pregnancy for girls experiencing depression onset before first sex also increased but was not significant (adjusted HR = 1.5, 95% CI: .82-2.76).
Timing of first depressive episode relative to age at first sexual intercourse plays a critical role in determining the risk of teenage pregnancy. Timely diagnosis and treatment of depression may not only help adolescents' mental well-being but may also help them prevent teenage pregnancy.
本研究旨在探讨抑郁发作相对于首次性行为年龄的时间是否与青少年怀孕有关。
利用来自全国共病调查-青少年补充调查中报告有过性行为的 1025 名青少年女孩的数据，我们应用 Cox 比例风险模型来检验与无抑郁发作相比，首次性行为前、与首次性行为同时或首次性行为后发生的抑郁发作是否与首次青少年怀孕有关。我们检查了抑郁状态的未调整风险以及青少年种族/民族、婚姻状况、贫困水平、是否居住在大都市区、居住状况、首次性行为年龄、父母教育程度和青少年出生时母亲年龄的调整风险。
在未调整和调整模型中，我们发现与无抑郁发作相比，首次性行为时发生抑郁发作的青少年怀孕风险增加（未调整的风险比[HR]为 2.5，95%置信区间[CI]：1.08-5.96；调整后的 HR 为 2.7，95%CI：1.15-6.34）。此外，与无抑郁发作相比，首次性行为前发生抑郁发作的女孩怀孕的风险也增加，但无统计学意义（调整后的 HR 为 1.5，95%CI：.82-2.76）。
首次抑郁发作相对于首次性行为的时间在决定青少年怀孕风险方面起着关键作用。及时诊断和治疗抑郁症不仅有助于青少年的心理健康，还可能帮助他们预防青少年怀孕。
