Pregnancy among insured adolescents [poster]
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Background: Birth to a teen mother is associated with increased risk for adverse outcomes, including preterm birth and low birth weight. Goals of this study were, in an insured population, to describe teen pregnancy rates and outcomes and to identify sub-populations of youth at increased risk for pregnancy. Methods: Using a validated, claims-based algorithm, we identified pregnancies occurring among adolescents 15-19 years of age with at least one year of continuous insurance from 2003-2010. We used descriptive statistics to compare teen pregnancy rates by age, year, race/ethnicity and type of insurance. Results: Our cohort included 73,199 teens and 93,491 person-years. The mean annual teen pregnancy rate was 44.6 per 1000 teens 15-19 years of age. Pregnancy rates increased markedly by age, from 12.4 per 1000 15 year-olds to 78.9 per 1000 19 year-olds. Trends in pregnancy rates by year were not observed. African American and Hispanic teens experienced pregnancy at rates over 4 times greater than white teens (137.8, 127.0 and 30.7 per 1000, respectively). Teens who were ever on public insurance had pregnancy rates more than 7 times greater than those never on public insurance (134.8 per 1000 versus 17.4 per 1000). Two-thirds of pregnancies ended in a live birth, one-fourth in a therapeutic abortion and the remainder resulted in spontaneous abortions. Hispanic youth and those ever on public insurance had lower rates of therapeutic abortions. Conclusion: In this insured cohort, African American and Hispanic youth, and adolescents with public insurance experienced markedly increased rates of teen pregnancy.