The Role of Mental Health Factors, Behavioral Factors, and Past Experience in the Prediction of Rapid Repeat Pregnancy in Adolescence

The United States continues to have the highest teenage pregnancy rate of any industrialized nation. Repeat and closely spaced pregnancies in teen mothers, however, are understudied even though these pregnancies may be at highest risk for poor outcomes. The authors interviewed 354 African-American adolescents (12-19 years) in Memphis, Tennessee during their pregnancies and again 24 months postpartum. They used logistic regression to study the relationship among mental health factors, behavioral factors and negative life experiences in predicting rapid repeat pregnancy (RRP).

Analyses indicated that the most potent predictors of RRP were age at first menarche and self-reported attitudes about aggression and self-efficacy. Adolescents who had RRPs agreed more often that people must use physical force to show importance and were less able to settle differences without using force. The authors conclude that their study suggests that measures of aggression should be included in longitudinal studies on determinants of RRP risk in adolescence. Also, this study did not show significant associations between life history factors such as abuse, a prior pregnancy with a poor outcome or mental health issues such as depression, and risk for RRPs.

Limitations of this study are that the population was extremely homogenous, and thus results may not be generalizable to other populations. Also, data were based on self-report, and therefore numerous biases may have affected them. Results of this study, however, are promising and indicate that perhaps new approaches to preventing teen pregnancy are warranted. Further research to understand the components of risk for RRPs is important for developing more effective strategies to prevent adolescent pregnancies.