The Good News:  According to the CDC, rates of teen pregnancy are falling  In the United States, 249,078 babies were born to women aged 15–19 years in 2014.  This represents a historic low for births among U.S. teens, a drop of 9% from 2013.

The Bad News:   Pregnant teens — especially when they don’t have the support of their families — often do not receive adequate prenatal care and are more likely to be poorly compliant with medical recommendations, including the use of folic acid which reduces the risk of certain types of birth defects. In addition, younger mothers are more likely to have pregnancy complications, including pregnancy-induced hypertension, preterm birth and low-birth-weight babies.  Children born to teen mothers are more likely to experience developmental delays and behavioral problems.

But the risks of teen pregnancy extend far beyond delivery.  Teen pregnancies are more common among women of color and those with lower education and lower socioeconomic status; in this population, unplanned pregnancies reduce women’s access to education and career opportunities and may contribute to educational and professional underachievement and poorer economic circumstances.

In addition, teen parents are at increased risk for significant mental health problems.  Our current research indicates that adolescent mothers experience higher rates of depression during pregnancy and the postpartum period, as compared to older mothers and their nonpregnant peers, rates of depression estimated to be between 16% and 44% in adolescent mothers. In contrast, the prevalence of depression in older mothers is between 10% and 15%.  We know less about the longterm effects of teen pregnancy on mental health outcomes.  One study of African American women who became mothers during adolescence found a twofold increase in the prevalence of depression 20 years after the birth of their first child.

In teen parents, there is a confluence of multiple psychosocial risk factors, including poverty, lower education level, inadequate social supports, and exposure to physical and emotional abuse.  These factors increase teen mothers’ vulnerability to postpartum depression and may interfere with accessing appropriate care. Treatment is a challenge in this population as pregnant adolescents are poorly adherent with mental health services, so we clearly need innovative and effective programs that support and address the mental health needs of adolescent mothers.

Ruta Nonacs, MD PhD

Hodgkinson S, Beers L, Southammakosane C, Lewin A. Addressing the mental health needs of pregnant and parenting adolescents. Pediatrics. 2014;133:114–22.

Resources:

Information on Teen Pregnancy from the CDC