Depression linked to subsequent pregnancy in black teens

Beth Barnet, M.D. Associate Professor of Family and Community Medicine. Department Family and Community Medicine. Special Interests: Adolescent Health. Medical Degree: George Washington University. Residency: Thomas Jefferson University Hospital, Family and Community Medicine. Fellowship: Johns Hopkins Hospital, Adolescent Medicine, Pediatrics. Certification: Family Medicine Contact Information: 1-800-373-4111 (physicians only), 1-800-492-5538 (patients and general information), 1-410-328-8919 (news media only)

African American adolescent mothers who have symptoms of depression may be more likely to have a subsequent pregnancy within two years of giving birth, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. Studies indicate that teen mothers are twice as likely to experience depression as adult mothers with almost twice as many African American teen mothers affected compared with white teen mothers, according to background information in the article. Rapid subsequent pregnancy (occurring within 24 months of a birth) is common in young mothers. “A recent meta-analysis found that 19 percent of teen mothers experienced a subsequent pregnancy within 12 months and 38 percent experienced a subsequent pregnancy within 24 months. The highest rates are among younger, economically disadvantaged African American adolescents.” Depression and subsequent pregnancy are associated with parenting stress and negative parenting behaviors such as child abuse and neglect. Beth Barnet, M.D., and colleagues at the University of Maryland School of Medicine, Baltimore, followed 269 predominantly African American teens (ages 12 to 18) with low income who received prenatal care at five community sites.

Questionnaires were completed one or two years after childbirth to measure depressive symptoms and occurrence of subsequent pregnancy.

Among those who completed at least one follow-up questionnaire, 46 percent had depressive symptoms at the beginning of the study. A pregnancy within two years of childbirth was experienced by 120 (49 percent) of the 245 teens followed up through two years and 28 (10 percent) had more than one subsequent pregnancy. The average time between subsequent pregnancies was 11.4 months. “Teens having a subsequent pregnancy were more likely to be school dropouts; not use condoms consistently at follow-up; and report a relationship with their baby’s father, who tended to be older,” the authors write. Depressive symptoms were associated with a 44 percent increase in risk of subsequent pregnancy.

“Depression is unhealthy for mothers and their children. Treating maternal depression improves the health and well-being of both,” the authors conclude. “Our findings do not tell us how depression might fit into a casual pathway to repeat adolescent childbearing, but they do suggest that depression may be an important malleable risk factor.”

“Because depression is treatable, future studies should evaluate whether improved recognition and treatment of adolescent depression reduces the risk of rapid subsequent pregnancy.” ###

(Arch Pediatr Adolesc Med. 2008;162[3]:246-252. Available pre-embargo to the media at www.jamamedia.org.)

Editor’s Note: This study was supported by grants from the Office of Adolescent Pregnancy Programs, U.S. Department of Health and Human Services and from an AAMC/CDC Cooperative Agreement. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Contact: Sharon Boston 410-328-8919 JAMA and Archives Journals