Predictors of Repeat Pregnancy in a Program for Pregnant Teens

Study Objective: To describe repeat pregnancy among adolescents and to compare those who experienced a repeat pregnancy to those who did not. Design, Setting, Participants: Retrospective case control of all adolescents who entered and exited the Teen Mother & Child Program, a multidisciplinary clinic for pregnant and parenting teens and their children, between 1985 and 2000. Main Outcome Measure: Repeat pregnancy. Results: Over the 16-yr study period, 1838 teens entered and exited the program with the mean time in the program of 1.9 yrs. 194 (10.6%) teens went on to have a second pregnancy, and 4 of those had a third pregnancy. Ninety-two percent (n = 175) of these pregnancies resulted in a live birth. The mean interval between delivery of the initial child and delivery of the second child was 21.8 months (range 5.4–53.2). Teens repeating (R) were compared to those who did not repeat (NR). R were younger at entry and older at exit from the program (both P<0.0001). R were more likely to be Hispanic (P = 0.009) or have a partner who was Hispanic (P = 0.02). R were more likely to have experienced a poor initial pregnancy outcome (miscarriage, stillbirth) (P = 0.03). R were more likely than NR to be in a stable relationships with the father of the baby (i.e., married or engaged) (P = 0.03). Self-report of physical and sexual abuse, depression, and substance abuse were common, but did not differ between R and NR. However, R were more likely than NR to self-report suicide gestures/attempts and to have a significant psychiatric history (P = 0.01, P = 0.004). Only 24% of R and 26% of NR had completed high school by the time of exit from the program. Conclusions: Ten percent of adolescents served by comprehensive multidisciplinary teen pregnancy program experienced a repeat pregnancy while in the program. Compared to nonrepeaters, adolescents who experienced a repeat pregnancy were younger, were more frequently Hispanic, and were more likely to be in a stable relationship with the babyʹs father. Many of the programʹs clients have psychosocial factors reported in the literature to be associated with repeat pregnancy. A history of suicide gestures/attempts and a significant psychiatric history were more common in those who had a repeat pregnancy. Disappointingly, only about 25% of the adolescents completed high school by the time they exited the program whether they experienced a repeat pregnancy or not. Although directing interventions (e.g., mental health services, counseling those who miscarried) to teens who appear to be at highest risk for a repeat pregnancy may decrease their risk of repeating, all teens in our program would likely benefit from such services.