| Abstract: | Higher levels of obstetric risk observed among teenage mothers seem to be an artifact of lower socioeconomic status and inferior access to health care rather than biological immaturity. In a study of matched Arkansas birth-infant death records for 1978, the proxy variables for health access (month care started and number of visits) have the strongest association with each of the dependent variables. The indicators of social status (education, race, and marital status) have a weaker association, and there is virtually no age effect observable once the affects of socioeconomic status and health access have been controlled for. A series of stepwise regression analyses shows that the multiple partial for health access indicators and mortality is 0.036, while the same coefficients for social status indicators and age are 0.001 and 0.006, respectively. Similar results are obtained using the other dependent variables. Health consequences of adolescent pregnancy usually include higher rates of malnutrition and prematurity and lower birth weight. It seems that the elevated morbidity and mortality among newborns delivered by teenagers are not a result of biologic factors. After the effects of lower status and health care access have been removed, the apparent biological disadvantages attributed to teenagers disappear, and, in the case of mortality and birth weight, are replaced by a slight advantage. This advantage is observed through the use of statisitical controls and will not be observed in the population at large unless there are changes in the policies governing access to contraception, abortion, and health care by adolescents, especially those at the youngest ages. |
