Developmentally Specific Predictors of Repeat Pregnancies in Adolescent Girls

In the United States, 30-50% of adolescent mothers experience a repeat pregnancy within 24 months of the first birth (Sangalang, Barth, & Painter, 2006). Many of the negative effects of adolescent first birth (e.g. poor academic achievement, ill-health effects for the mother and child, economic hardship) are compounded by a second pregnancy (Key, Barbosa & Owens, 2001; King, 2003), especially among urban-living, minority race adolescents (Klerman, Cliver & Goldenberg, 1998). A range of factors (e.g. age, SES, race, contraceptive use, future orientation) are associated with rapid repeat pregnancy (RRP) but there is little consensus as to which risk factors are most important. In addition, many studies are cross-sectional, adolescent pregnancies occurring beyond 24 months are not considered, and predictors are frequently developmentally ‘static’ or based on retrospective reports. Given the limited success of prevention programs (e.g. Katz, Rodan, Milligan et al., 2011), it seems clear that a more developmentally informed approach is needed.

The current study used multiple waves of data collected across adolescence from the longitudinal Pittsburgh Girls Study (PGS), to examine the predictive utility of factors, assessed around the time of first pregnancy, on time to second pregnancy. The PGS is a multiple-cohort, urban community sample of African American and European American girls (N=2,451) followed annually for 13 years since mid-childhood. By ages 16-19, 411 (16.8%) adolescents had reported one or more pregnancies. Among this group, 25.1% (N=103) reported two or more additional pregnancies and were included in survival analyses.  Using a stepwise method, the base model revealed that neither sociodemographic factors (household poverty, minority race, living with a single parent, low parental education), nor inconsistent use of birth control predicted time to second pregnancy in this sample. After controlling for these variables however, weaker attachment to mother at the time of first pregnancy significantly predicted shorter time to second pregnancy (Odds ratio=.94, 95%CI=.88-.98). This effect remained after also controlling for the marginal effects of lower future orientation. Further analyses will explore factors that characterize distinct clusters of girls who become pregnant more than once in adolescence, with potentially important implications for tailoring preventive programs.