Double Jeopardy: Depressive Symptoms and Rapid Subsequent Pregnancy in Adolescent Mothers

Abstract

ABSTRACT

Adolescent mothers in the United States are twice as likely as adults to become depressed, and African Americans seem to be especially at risk. A recent meta-analysis showed that nearly 1 in 5 teen mothers had another pregnancy within 12 months, and nearly 40% within 2 years. Both rapid subsequent pregnancy and maternal depression are associated with an increased risk of child abuse and neglect, as well as impaired intellectual development and psychosocial functioning. This study evaluated depressive symptoms using the Center for Epidemiological Studies Depression Scale in 269 pregnant teenagers age 12–18 years who were seen at 5 community-based prenatal sites. The subjects—predominantly low-income African Americans—were interviewed 1 and 2 years after delivery.

Nearly half of the 245 teens followed until 2 years postpartum had at least one subsequent pregnancy, and 10% had more than one. One-third of 24 participants had another pregnancy within 12 months. The mean interval between the index birth and first subsequent pregnancy was 11.4 months. The teens who had a subsequent pregnancy were more likely to have dropped out of school, to not use condoms consistently, and to claim a relationship with their infant’s father. Subsequent pregnancies were significantly more frequent in teens having depressive symptoms at baseline, even after adjusting for numerous possible confounding factors. In addition, teens with depressive symptoms tended to have a subsequent pregnancy significantly sooner after the index birth compared to those without such symptoms.

These findings suggest that, in teenage mothers, depression may be an important and independent risk factor for a subsequent pregnancy within 1 to 2 years of an index pregnancy. Because depression is treatable, it will be of interest to learn whether better recognition will lessen the risk of a rapid subsequent pregnancy.