Health behaviors and prenatal health conditions in repeat versus first-time teenage mothers in the United States: 2015-2018.

STUDY OBJECTIVE: Repeat teenage mothers, those who give birth to a second or higher order infant prior to age 20, are at elevated risk for adverse perinatal outcomes compared to first-time teenage mothers. The objective of the current study was to compare the prevalence of negative pregnancy-related behaviors and gestational health conditions in the national United States population of first-time and repeat teenage mothers.

DESIGN: Setting, and Participants: We conducted a retrospective, population-based cohort study using annual US birth data files from 2015-2018, N=799,756 (84.2% first, 15.8% repeat) births to women ages 15-19 years.

INTERVENTIONS: None.

MAIN OUTCOME MEASURES: Pregnancy-related behaviors (including adequacy of prenatal care and weight gain, sexually transmitted infection, smoking, and breastfeeding) and gestational health conditions (gestational hypertension and gestational diabetes).

RESULTS: Repeat (versus first-time) mothers had higher prevalence of negative pregnancy-related behaviors: inadequate prenatal care, smoking, inadequate weight gain, and sexually transmitted infection during pregnancy; they were also less likely to breastfeed. Conversely, repeat teenage mothers experienced lower prevalence of gestational hypertension and gestational diabetes.

CONCLUSION: Repeat teenage mothers experienced lower prevalence of physical health complications during pregnancy but engaged in more negative pregnancy-related health behaviors. Negative health behavior in pregnancy can lead directly to poor perinatal outcomes for infants. To prevent adverse outcomes from repeat teenage childbearing, we must ensure access to quality, timely prenatal and postpartum care where teenage mothers can receive support for healthy pregnancy-related behaviors as well as linkage to highly effective contraception to prevent unintended repeat births.