A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Increased risk of premature death following teenage abortion and childbirth-a longitudinal cohort study
Tekijät: Jalanko E, Leppälahti S, Heikinheimo O, Gissler M
Kustantaja: OXFORD UNIV PRESS
Julkaisuvuosi: 2017
Journal: European Journal of Public Health
Tietokannassa oleva lehden nimi: EUROPEAN JOURNAL OF PUBLIC HEALTH
Lehden akronyymi: EUR J PUBLIC HEALTH
Vuosikerta: 27
Numero: 5
Aloitussivu: 845
Lopetussivu: 849
Sivujen määrä: 5
ISSN: 1101-1262
DOI: https://doi.org/10.1093/eurpub/ckx065
Tiivistelmä
Teenage pregnancy is associated with an increased risk of premature death. However, it is not known whether the outcome of pregnancy, i.e. induced abortion or childbirth, affects this risk.A Finnish population-based register study involving a cohort of 13 691 nulliparous teenagers who conceived in 1987-89; 6652 of them underwent induced abortion and 7039 delivered. The control group consisted of 41 012 coeval women without teenage pregnancy. Follow-up started at the end of pregnancy and lasted until 6th June 2013.Women with teenage pregnancy had a higher risk of overall mortality vs. controls (mortality rate ratio [MRR] 1.6, [95% CI 1.4-1.8]) and were more likely to die prematurely as a result of suicide, alcohol-related causes, circulatory diseases and motor vehicle accidents. A low educational level appeared to explain these excess risks, except for suicide (adj. MRR 1.5, [95% CI 1.1-2.0]). After adjusting for confounders, the childbirth group faced lower risks of suicide (adj. MRR 0.5, [95% CI 0.3-0.9]) and dying from injury and poisoning (adj. MRR 0.6, [95% CI 0.4-0.8]) compared with women who had undergone abortion.A low educational level is associated with the increased risk of premature death among women with a history of teenage pregnancy, except for suicide. Extra efforts should be made to encourage pregnant teenagers to continue education, and to provide psychosocial support to teenagers who undergo induced abortion.
Teenage pregnancy is associated with an increased risk of premature death. However, it is not known whether the outcome of pregnancy, i.e. induced abortion or childbirth, affects this risk.A Finnish population-based register study involving a cohort of 13 691 nulliparous teenagers who conceived in 1987-89; 6652 of them underwent induced abortion and 7039 delivered. The control group consisted of 41 012 coeval women without teenage pregnancy. Follow-up started at the end of pregnancy and lasted until 6th June 2013.Women with teenage pregnancy had a higher risk of overall mortality vs. controls (mortality rate ratio [MRR] 1.6, [95% CI 1.4-1.8]) and were more likely to die prematurely as a result of suicide, alcohol-related causes, circulatory diseases and motor vehicle accidents. A low educational level appeared to explain these excess risks, except for suicide (adj. MRR 1.5, [95% CI 1.1-2.0]). After adjusting for confounders, the childbirth group faced lower risks of suicide (adj. MRR 0.5, [95% CI 0.3-0.9]) and dying from injury and poisoning (adj. MRR 0.6, [95% CI 0.4-0.8]) compared with women who had undergone abortion.A low educational level is associated with the increased risk of premature death among women with a history of teenage pregnancy, except for suicide. Extra efforts should be made to encourage pregnant teenagers to continue education, and to provide psychosocial support to teenagers who undergo induced abortion.