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Citation
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Goueslard K, Jollant F, Cottenet J, Bechraoui-Quantin S, Rozenberg P, Simon E, Quantin C. BJOG 2023; ePub(ePub): ePub. |
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Abstract
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OBJECTIVES: To evaluate the risk of non-lethal self-harm and mortality related to adolescent pregnancy.
DESIGN: Nationwide population-based retrospective cohort. SETTING: Data were extracted from the French national health data system. POPULATION: We included all adolescents aged 12 to 18 years with an ICD-10 code for pregnancy in 2013-2014.
METHODS: Pregnant adolescents were compared to age-matched non-pregnant adolescents, and to first-time pregnant women aged 19-25 years. MAIN OUTCOME MEASURES: Any hospitalization for non-lethal self-harm and mortality during a three-year follow-up period. Adjustement variables were age, a history of hospitalization for physical diseases, psychiatric disorders, self-harm, and reimbursed psychotropic drugs. Cox proportional hazards regression models were used.
RESULTS: In 2013-2014, 35,449 adolescent pregnancies were recorded in France. After adjustment, pregnant adolescents had an increased risk of subsequent hospitalization for non-lethal self-harm in comparison to both non-pregnant adolescents (n=70,898) (1.3 vs. 0.2%, hazard ratio (HR) 3.06, 95% confidence intervals (2.57 to 3.66)), and pregnant young women (n=233,406) (0.5%, HR 2.41, (2.14 to 2.71)). Rates of hospitalization for non-lethal self-harm were lower during pregnancy and higher between 12 and 8 months pre-delivery, 3 to 7 months postpartum, and in the month following abortion. Mortality was significantly higher in pregnant adolescents (0.7‰) vs. pregnant young women (0.4‰, HR=1.74, (1.12 to 2.72)) but not vs. non-pregnant adolescents (0.4‰, 1.61, (0.92 to 2.83)).
CONCLUSIONS: Adolescent pregnancy is associated with an increased risk of hospitalization for non-lethal self-harm and premature death. Careful psychological evaluation and support should be systematically implemented in pregnant adolescents.
Language: en |