Teen pregnancy linked to risk of earlier death in adulthood, research shows

Teenage pregnancies increase the likelihood of a young woman dropping out of school and struggling with poverty, research shows. Teens are also more likely to develop serious medical complications during pregnancy.

Now a major study in Canada reports another disturbing finding: Women who were pregnant as teenagers are more likely to die before their 31st birthday. The trend was observed in women who had completed a teenage pregnancy, as well as in women who had had a miscarriage.

“The younger the person was when she became pregnant, the greater the risk of premature death,” said Dr. Joel G. Ray, an obstetric medicine specialist and epidemiologist at St. Michael’s Hospital in Toronto and the study’s first author . It was published Thursday in JAMA Network Open.

“Some people will argue that we shouldn’t judge this, but I think we have always intuitively known that there is an age that is too young for pregnancy,” he added.

The study used a provincial health insurance registry to analyze pregnancy outcomes for approximately 2.2 million teens in Ontario, Canada, including all girls who were 12 years old between April 1991 and March 2021.

Even after the researchers took into account pre-existing health problems the girls might have had, as well as income and education differences, teens who carried a pregnancy to term were more than twice as likely to die prematurely later in life.

The researchers found similar odds among women who had an ectopic pregnancy as a teenager, in which the fertilized egg grows outside the uterus, or in pregnancies that ended in a stillbirth or miscarriage.

The danger was significantly lower in women who had terminated a pregnancy as a teenager; however, they were still 40 percent more likely to die prematurely, compared to women who had not been pregnant.

Dr. Ray and his colleagues found that the greatest risk of premature death was among women who became pregnant before the age of 16 and among women who were pregnant more than once as a teenager.

Injuries – both self-inflicted and unintentional, such as seizures – caused the most premature deaths, the analysis found.

Women who had been pregnant as a teenager were more than twice as likely to die from an unintentional injury at a young age, compared to women who had not been pregnant as a teenager – and they were also twice as likely to die from an self-inflicted injury.

In a commentary accompanying the article, Elizabeth L. Cook, a scientist at Child Trends, a research organization focused on children and youth, noted that teen pregnancy may not be a causal factor in premature death.

Rather, it may be indicative of a range of other influences, including adverse childhood experiences, that increase the likelihood of an early death. She called for more research to understand these causes.

While some teens choose to become pregnant, “most teen pregnancies are unintended, exposing shortcomings in the systems that exist to educate, guide and support young people,” Ms. Cook wrote. The stigma and isolation that many pregnant teens face “can make it harder to thrive in adulthood,” she added. The new study is not the first to find a link between teen pregnancy and premature death, but appears to be one of the largest and most robust.

A Finnish study reported in 2017 that women who had had a teenage pregnancy were more likely to die prematurely due to suicide, alcohol-related causes, circulatory disorders and car accidents. That study attributed the additional risk to a low level of education.

Although the risks of pregnancy generally increase with age, pregnant adolescents are more likely than women in their 20s and 30s to develop pregnancy-related high blood pressure and a life-threatening condition called preeclampsia.

They are more likely to give birth prematurely and have babies that are small at birth, and their babies often have other serious health problems and are at greater risk of dying during their first year of life.