Teenage pregnancy increases a young woman’s chances of dropping out of school and struggling with poverty, research has shown. Teenagers are also more likely to develop serious medical complications during pregnancy.
Now a large Canadian study reports another troubling finding: Women who were pregnant as teenagers are more likely to die before their 31st birthday. The trend was seen among women who had completed teenage pregnancies, as well as among those who had miscarried.
“The younger the person was when they got pregnant, the greater the risk of premature death,” said Dr. Joel G. Ray, an obstetrician and epidemiologist at St. Michael’s in Toronto and first author of the study. It was published in JAMA Network Open on Thursday.
“Some people will argue that we shouldn’t be judgmental about it, but I think we’ve always known intuitively that there’s an age that’s too young to be pregnant,” she added.
The study used a provincial health insurance registry to analyze pregnancy outcomes in about 2.2 million teenagers in Ontario, Canada, including all girls who were 12 years old between April 1991 and March 2021.
Even after the researchers accounted for pre-existing health problems the girls may have had and for income and education disparities, teenage girls who completed their pregnancies were more than twice as likely to die prematurely later in life.
The researchers found similar odds among women who as teenagers had ectopic pregnancies, in which the fertilized egg grows outside the uterus, or pregnancies that ended in stillbirth or miscarriage.
The risk was significantly lower among women who had terminated a pregnancy as teenagers – however, they were still 40 per cent more likely to die prematurely, compared to those who were not pregnant.
Dr. Ray and his colleagues found the highest odds of early death among women who became pregnant before the age of 16 and those who were pregnant more than once as teenagers.
Injuries – both self-inflicted and unintentional, such as assaults – caused most of the premature deaths, the analysis found.
Women who were pregnant as teenagers were more than twice as likely to die young from unintentional injury, compared to those who were not pregnant as teenagers – and were also twice as likely to die from self-harm.
In a commentary accompanying the article, Elizabeth L. Cook, a scientist at Child Trends, a research organization focused on children and youth, noted that teenage pregnancy may not be a causative factor in premature mortality.
Rather, it may be a proxy for a number of other influences, including adverse childhood experiences, that increase the odds of early death. He called for more research to understand these causes.
While some teenagers choose to become pregnant, “most teenage pregnancies are unintended, which exposes the shortcomings in the systems that exist to educate, guide and support young people,” Ms Cook wrote. The stigma and isolation experienced by many pregnant teenagers “can make it more difficult to thrive in adulthood,” she added. The new study is not the first to find an association between teenage pregnancy and early death, but it appears to be one of the largest and most robust.
A Finnish study reported in 2017 that women who had experienced teenage pregnancy were more likely to die prematurely as a result of suicide, alcohol-related causes, circulatory diseases and traffic accidents. This study attributed the excess risk to low educational attainment.
Although pregnancy risks generally increase with age, pregnant teens are more likely than women in their 20s and 30s to develop pregnancy-related high blood pressure and a life-threatening condition called preeclampsia.
They are more likely to give birth prematurely and give birth to small babies, and their babies often have other serious health problems and are at greater risk of dying in their first year of life.
