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The pregnancy and post-partum experience is stressful, but for pregnant adolescents the barriers to accessing supportive care can have fatal consequences.

A recent study from researchers at Unity Health Toronto and The Hospital for Sick Children (SickKids) found that when compared with those who had no teen pregnancy, teenagers in Ontario who experienced a pregnancy were at a 50 per cent higher risk of premature death before the age of 31.

This risk was even higher for people who had two or more teen pregnancies and amongst those who were pregnant before 16 years of age.

Dr. Joel Ray

“Many deaths in women before age 40 years are from injury and suicide. Such deaths are more likely to occur among those who have had adverse childhood experiences,” said Dr. Joel Ray, clinician-scientist at St. Michael’s Hospital, a site of Unity Health Toronto, and lead author of the study. 

“Our study of 2.2 million teens showed that premature death was 1.5 times higher in those who had 1 teen pregnancy, and 2.1 times higher among those with at least 2 teen pregnancies. This was especially seen in women who had a teen pregnancy before age 16 years.”

Published in JAMA Network Open, the study also found that those who experience teen pregnancy were more likely to reside in lower-income neighbourhoods and areas with lower completion rates for high school education.

“We believe that teen pregnancy may sometimes reflect adverse life experiences, and is a potentially novel marker for premature mortality in early adulthood,” Ray said.

“Apparent protective factors for teen pregnancy include stable family, school and peer support, open communication with adult mentors or parents about contraception use, free access to contraception, and female empowerment to abstain from unwanted or unplanned intercourse.”

The research team, led by Ray, and co-led by Dr. Eyal Cohen, staff physician, senior scientist and program head of SickKids’ Child Health Evaluative Sciences program, used administrative data to capture all teen pregnancies (defined as pregnancy between 12 and 19 years of age) and deaths among 2.2 million people assigned female at birth who were alive at 12 years of age from 1991 to 2021.

“The longer-term risk of premature death, whether injury or noninjury-related, is significantly increased for pregnant teenagers,” says Cohen, who is the Co-Executive Director of the Edwin S.H. Leong Centre for Healthy Children. 

This study was supported by PSI Foundation, the Canadian Institutes of Health Research (CIHR) and ICES.

By: Sarah Warr, SickKids, and Adam Miller, Unity Health Toronto