Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-15T19:23:34.292Z Has data issue: false hasContentIssue false
  • English
  • Français

Teenage motherhood and risk of premature death: long-term follow-up in the ONS Longitudinal Study

Published online by Cambridge University Press:  28 January 2011

R. T. Webb ,
C. E. Marshall  and
K. M. Abel
R. T. Webb*
Affiliation:
Mental Health and Neurodegeneration Research Group, University of Manchester, Manchester Academic Health Science Centre, UK
C. E. Marshall
Affiliation:
CeLSIUS – Centre for Longitudinal Study Information and User Support Office, London School of Hygiene and Tropical Medicine, UK
K. M. Abel
Affiliation:
Centre for Women's Mental Health, University of Manchester, Manchester Academic Health Science Centre, UK
*
*Address for correspondence: Dr R. T. Webb, Mental Health and Neurodegeneration Research Group, Jean McFarlane Building, The University of Manchester, Oxford Road, Manchester M13 9PL, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Teenage motherhood is relatively common in the UK, but little is known about related health inequalities in this population. We estimated cause-specific mortality risks over three decades in a nationally representative cohort.

Method

We examined premature mortality in a 1.1% sample of all women who were teenagers in England and Wales during the 1970s, 1980s and 1990s using data from the Office for National Statistics Longitudinal Study (ONS LS). Our primary outcome was suicide. Long-term follow-up to 31 December 2006, to a potential maximum age of 49 years, was achieved through near-complete routine linkage to national mortality records. We created a time-dependent exposure variable, with relative risks estimated according to age when women first experienced motherhood versus a reference group of those currently without children.

Results

Women who were teenage mothers were around 30% more likely to die prematurely by any cause and almost 60% more likely to die unnaturally, whereas first-time motherhood at mature age conferred lower risk compared to women without children. Teenage motherhood was associated with a more than doubled risk of suicide [mortality rate ratio (MRR) 2.23, 95% confidence interval (CI) 1.30–3.83], and elevated risks of fatal cancer of the cervix and lung were also found. Changing the reference category to first-time mothers at 20 years and above also revealed a significant elevation in risk of accidental death.

Conclusions

The complex psychosocial needs of these women require greater attention from clinicians, public health professionals, social services and policymakers. Their elevated risk of poor health outcomes may persist well beyond the actual teenage motherhood years.

Keywords

Epidemiologymotherspregnancy in adolescencepsychosocial deprivationsuicide
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 9 , September 2011 , pp. 1867 - 1877
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Appleby, L (1991). Suicide during pregnancy and in the first postnatal year. British Medical Journal 302, 137–140.CrossRefGoogle ScholarPubMed
Bjørge, T, Øystein, K (1996). Reproductive variables and risk of uterine cervical cancer in Norwegian registry data. Cancer Causes and Control 7, 351–357.CrossRefGoogle ScholarPubMed
Breakwell, C, Baker, A, Griffiths, C, Jackson, G, Fegan, G, Marshall, D (2007). Trends and geographical variations in alcohol-related deaths in the United Kingdom, 1991–2004. Health Statistics Quarterly 33, 6–22.Google Scholar
Butterworth, P (2004). Lone mothers' experience of physical and sexual violence: association with psychiatric disorders. British Journal of Psychiatry 184, 21–27.CrossRefGoogle ScholarPubMed
Clayton, D, Hills, M (1993). Statistical Models in Epidemiology. Oxford University Press: Oxford.Google Scholar
Copeland, KT, Checkoway, H, Holbrook, RH, McMichael, AJ (1977). Bias due to misclassification in the estimate of relative risk. American Journal of Epidemiology 105, 488–495.CrossRefGoogle ScholarPubMed
Department for Children, Schools and Families (2010). About the teenage pregnancy strategy (www.dcsf.gov.uk/everychildmatters/healthandwellbeing/teenagepregnancy/about/strategy/). Accessed 14 October 2010.Google Scholar
Department of Health (2010). Health profile of england 2009. Department of Health: London (www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_114561). Accessed 14 October 2010.Google Scholar
Dietz, PM, Rochat, RW, Thompson, BL, Berg, CJ, Griffin, GW (1998). Differences in the risk of homicide and other fatal injuries between postpartum women and other women of childbearing age: implications for prevention. American Journal of Public Health 88, 641–643.CrossRefGoogle ScholarPubMed
Dolhammer, G (2000). Reproductive history and mortality in later life: a comparative study of England and Wales and Austria. Population Studies 54, 169–176.CrossRefGoogle Scholar
Gardner, JW, Sanborn, JS (1990). Years of potential life lost (YPLL) – what does it measure? Epidemiology 1, 322–329.CrossRefGoogle ScholarPubMed
Gardner, W, Mulvey, EP, Shaw, EC (1995). Regression analyses of counts and rates: Poisson, overdispersed Poisson, and negative binomial models. Psychological Bulletin 118, 392–404.CrossRefGoogle ScholarPubMed
Geronimus, AT, Koreman, S, Hillemeier, MM (1994). Does young maternal age adversely affect child development? Evidence from cousin comparisons in the United States. Population Development Review 20, 585–609.CrossRefGoogle Scholar
Grundy, E, Tomassini, C (2005). Fertility history and health in later life: a record linkage study in England and Wales. Social Science and Medicine 61, 217–228.CrossRefGoogle ScholarPubMed
Gunnell, D, Middleton, N (2003). National suicide rates as an indicator of the effect of suicide on premature mortality. Lancet 362, 961–962.CrossRefGoogle Scholar
Hobcroft, J, Kiernan, K (2001). Childhood poverty, early motherhood and adult social exclusion. British Journal of Sociology 52, 495–517.CrossRefGoogle Scholar
Johns, SE (2010). Perceived environmental risk as a predictor of teenage motherhood in a British population. Health & Place. Published online: 18 September 2010. doi:10.1016/j.healthplace.2010.09.006.Google Scholar
Kessler, RC, Berglund, PA, Foster, CL, Saunders, WB, Stang, PE, Walters, EE (1997). Social consequences of psychiatric disorders, II: Teenage parenthood. American Journal of Psychiatry 154, 1405–1411.Google ScholarPubMed
Kiernan, KE (1997). Becoming a young parent: a longitudinal study of associated factors. British Journal of Sociology 48, 406–428.CrossRefGoogle Scholar
Kovacs, M, Krol, RS, Voti, L (1994). Early onset of psychopathology and the risk for teenage pregnancy among clinically referred girls. Journal of the American Academy of Child and Adolescent Psychiatry 33, 106–113.CrossRefGoogle ScholarPubMed
Linehan, MM, Goodstein, JL, Nielsen, SL, Chiles, JA (1983). Reasons for staying alive when you are thinking of killing yourself: the reasons for living inventory. Journal of Consulting and Clinical Psychology 51, 276–286.CrossRefGoogle ScholarPubMed
Linsley, KR, Schapira, K, Kelly, TP (2001). Open verdict v. suicide – importance to research. British Journal of Psychiatry 178, 465–468.CrossRefGoogle ScholarPubMed
Maughan, B, Lindelow, M (1997). Secular change in psychosocial risks: the case of teenage motherhood. Psychological Medicine 27, 1129–1144.CrossRefGoogle ScholarPubMed
McGhee, R, Williams, S (1996). Predictors of persistent smoking and quitting among women smokers. Addictive Behaviors 31, 1711–1715.CrossRefGoogle Scholar
McLeod, A (2001). Changing patterns of teenage pregnancy: population based study of small areas. British Medical Journal 323, 199–203.CrossRefGoogle ScholarPubMed
Moffitt, TE, the E-Risk Study Team (2002). Teen-aged mothers in contemporary Britain. Journal of Child Psychology and Psychiatry 43, 727–742.CrossRefGoogle ScholarPubMed
Morris, R, Carstairs, V (1991). Which deprivation? A comparison of selected deprivation indices. Journal of Public Health Medicine 13, 318–325.Google Scholar
Norman, P (2010). Identifying change over time in small area socio-economic deprivation. Applied Spatial Analysis and Policy 3, 107–138.CrossRefGoogle Scholar
Norman, P, Boyle, P, Rees, P (2005). Selective migration, health and deprivation: a longitudinal analysis. Social Science and Medicine 60, 2755–2771.CrossRefGoogle ScholarPubMed
Otterblad-Olausson, P, Haglund, B, Ringbäck Weitoft, G, Cnattinguis, S (2001). Teenage childbearing and long-term socioeconomic consequences: a case study in Sweden. Family Planning Perspectives 33, 70–74.CrossRefGoogle Scholar
Otterblad-Olausson, P, Haglund, B, Ringbäck Weitoft, G, Cnattingius, S (2004). Premature death among teenage mothers. BJOG: An International Journal of Obstetrics and Gynaecology 111, 793–799.CrossRefGoogle ScholarPubMed
Quinlivan, JA, Tan, LH, Steele, A, Black, K (2004). Impact of demographic factors, early family relationships and depressive symptomatology in teenage pregnancy. Australian and New Zealand Journal of Psychiatry 38, 197–203.CrossRefGoogle ScholarPubMed
Ringbäck Weitoft, G, Haglund, B, Anders, H, Mans, R (2002). Mortality, severe morbidity and injury among long-term lone mothers in Sweden. International Journal of Epidemiology 31, 573–580.CrossRefGoogle Scholar
Robson, K, Berthoud, R (2003). Teenage motherhood in Europe: a multi-country analysis of socioeconomic outcomes. European Sociological Review 19, 451–466.CrossRefGoogle Scholar
Sarfati, D, Scott, KM (2001). The health of lone mothers in New Zealand. New Zealand Medical Journal 114, 257–260.Google ScholarPubMed
Sloggett, A, Joshi, H (1994). Higher mortality in deprived areas: community or personal disadvantage? British Medical Journal 309, 1470–1474.CrossRefGoogle ScholarPubMed
Sloggett, A, Joshi, H (1998). Deprivation indicators as predictors of life events 1981–1992 based on the UK ONS Longitudinal Study. Journal of Epidemiology and Community Health 52, 228–233.CrossRefGoogle ScholarPubMed
StataCorp (2008). Stata Statistical Software: Release 10.0. Stata Corporation: College Station, TX.Google Scholar
Targosz, S, Bebbington, P, Lewis, G, Brugha, T, Jenkins, R, Farrell, M, Meltzer, H (2003). Lone mothers, social exclusion and depression. Psychological Medicine 33, 715–722.CrossRefGoogle ScholarPubMed
Turley, RNL (2003). Are children of young mothers disadvantaged because of their mother's age or family background? Child Development 74, 465–474.CrossRefGoogle ScholarPubMed
WHO (1967). Manual of the International Classification of Diseases (ICD-8). World Health Organization: Geneva.Google Scholar
WHO (1977). International Classification of Diseases, Ninth Revision (ICD-9). World Health Organization: Geneva.Google Scholar
WHO (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization: Geneva.Google Scholar
Williams, S, McGhee, R, Olaman, S, Knight, R (1997). Level of education, age of bearing children and mental health of women. Social Science and Medicine 45, 827–836.CrossRefGoogle ScholarPubMed