Department of Health Sciences, Department of Economics, Northeastern University, Boston, MA, USA.
Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Room S113 - 750 Bannatyne Avenue, Winnipeg, MB, R3E 0W3, Canada.
BMC Pregnancy Childbirth. 2023 Mar 4;23(1):140. doi: 10.1186/s12884-023-05443-6.
Understanding the relationship between adolescent pregnancy and adult education and employment outcomes is complicated due to the endogeneity of fertility behaviors and socio-economic functioning. Studies exploring adolescent pregnancy have often relied on limited data to measure adolescent pregnancy (i.e. birth during adolescence or self-reports) and lack access to objective measures of school performance during childhood.
We use rich administrative data from Manitoba, Canada, to assess women's functioning during childhood (including pre-pregnancy academic performance), fertility behaviors during adolescence (live birth, abortion, pregnancy loss, or no history of pregnancy), and adult outcomes of high school completion and receipt of income assistance. This rich set of covariates allows calculating propensity score weights to help adjust for characteristics possibly predictive of adolescent pregnancy. We also explore which risk factors are associated with the study outcomes.
We assessed a cohort of 65,732 women, of whom 93.5% had no teen pregnancy, 3.8% had a live birth, 2.6% had abortion, and < 1% had a pregnancy loss. Women with a history of adolescent pregnancy were less likely to complete high school regardless of the outcome of that pregnancy. The probability of dropping out of high school was 7.5% for women with no history of adolescent pregnancy; after adjusting for individual, household, and neighborhood characteristics, the probability of dropping out of high school was 14.2 percentage points (pp) higher (95% CI 12.0-16.5) for women with live birth, 7.6 pp. higher (95% CI 1.5-13.7) for women with a pregnancy loss, and 6.9 pp. higher (95% CI 5.2-8.6) for women who had abortion. They key risk factors for never completing high school are poor or average school performance in 9th grade. Women who had a live births during adolescence were much more likely to receive income assistance than any other group in the sample. Aside from poor school performance, growing up in poor households and in poor neighborhoods were also highly predictive of receiving income assistance during adulthood.
The administrative data used in this study enabled us to assess the relationship between adolescent pregnancy and adult outcomes after controlling for a rich set of individual-, household-, and neighborhood-level characteristics. Adolescent pregnancy was associated with higher risk of never completing high school regardless of the pregnancy outcome. Receipt of income assistance was significantly higher for women having a live birth, but only marginally higher for those who had a pregnancy that ended in loss or termination, underlining the harsh economic consequences of caring for a child as a young mother. Our data suggest that interventions targeting young women with poor or average school marks may be especially effective public policy priorities.
由于生育行为和社会经济功能的内生性，理解青少年怀孕与成人教育和就业结果之间的关系很复杂。探索青少年怀孕的研究往往依赖于有限的数据来衡量青少年怀孕（即青春期怀孕或自我报告），并且缺乏对儿童时期学校表现的客观衡量。
我们使用来自加拿大马尼托巴省的丰富行政数据来评估女性在儿童时期的功能（包括怀孕前的学业成绩）、青少年时期的生育行为（活产、堕胎、流产或无妊娠史）以及高中完成和获得收入援助的成年结果。这组丰富的协变量允许计算倾向评分权重，以帮助调整可能预测青少年怀孕的特征。我们还探讨了哪些风险因素与研究结果相关。
我们评估了一个由 65732 名女性组成的队列，其中 93.5%的女性没有青少年怀孕，3.8%的女性有活产，2.6%的女性堕胎，<1%的女性流产。无论怀孕结果如何，有青少年怀孕史的女性完成高中学业的可能性较低。没有青少年怀孕史的女性辍学的概率为 7.5%；在调整个人、家庭和社区特征后，活产女性辍学的概率高 14.2 个百分点（95%CI 12.0-16.5），流产女性辍学的概率高 7.6 个百分点（95%CI 1.5-13.7），堕胎女性辍学的概率高 6.9 个百分点（95%CI 5.2-8.6）。从未完成高中学业的关键风险因素是 9 年级时学业成绩差或一般。在青春期有活产的女性比样本中的任何其他群体更有可能获得收入援助。除了学业成绩不佳外，在贫困家庭和贫困社区长大也是成年后获得收入援助的高度预测因素。
本研究使用的行政数据使我们能够在控制了一系列丰富的个人、家庭和社区层面特征后，评估青少年怀孕与成人结果之间的关系。青少年怀孕与从未完成高中学业的风险增加有关，无论怀孕结果如何。有活产的女性获得收入援助的比例显著更高，但因流产或终止妊娠而怀孕的女性仅略有增加，这突出了年轻母亲照顾孩子的经济后果的严重性。我们的数据表明，针对学业成绩差或一般的年轻女性的干预措施可能是特别有效的公共政策重点。
