Adolescent Pregnancy

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One in every six births in developing countries (one in 10 worldwide) is to a 15- to 19-year-old adolescent (18). Over half of females become mothers by

Table 3 Factors Contributing to Adolescent Pregnancy

Decreased age at menarche Delay of marriage Poverty

Lack of education

Inadequate contraceptive knowledge and availability Cultural factors specific to that specific country/subpopulation Sexual abuse age 19 in developing countries. Over 14 million adolescent females give birth each year, with 5.7 million in Asia, 4.5 million in Sub-Saharan Africa, 2.1 million in the Middle East, as well as North Africa, and 1.3 million in developed countries (3,4,19,20). There are many factors involved in the rate of adolescent pregnancy in a country, as listed in Table 3. Table 4 notes percentages of adolescents aged 15 to 19 years giving birth in various countries (3).

About 9% of adolescent females in the United States become pregnant each year, with 5% delivering, 3% having an abortion, and 1% have a miscarriage or stillbirth (21-25).

Adolescent pregnancy under age 15 remains a relatively uncommon phenomenon throughout the world. Currently, approximately 43% of American adolescent females become pregnant at least once before age 20. Adolescent females account for 13% of all births in the United States (4,158,212 in 1992) and 26% of all abortions (about 400,000) (25). The 2004 birth rate of 41.1 per 1000 females aged 15 to 19 years in the United States is the highest among all developed nations and is in stark contrast to Japan (4 per 1000), the Netherlands (7 per 1000), France (10 per 1000), Canada (25 per 1000) or the United Kingdom (28 per 1000) (21,26,27). Though there has been some decline in adolescent birth rates in the United States from the 1990s through 2004, the U.S. rate remains the highest of any developed country (Table 5). Adolescent sexual behavior is similar in the United States and other developed countries; however, there is less access to comprehensive sexuality

Table 4 Adolescents Aged 15 to 19 Years Giving Birth in Various Counties

1% in Japan

2% in China and Europe 4% in Asia 5% in North America 12% in Africa 18% in Pakistan 28% in India

Table 5 Birth Rates Among American Adolescents Aged 15-19 Years per 1000

Highest rates: 1950s-1960s

1970: 66

1986: 50.2

1990: 60

1997: 53

2000: 48.5

2001: 44.9

2004: 41.1 (ranging from 18.2 in New Hampshire to 62.6 in Texas) Source: Adapted from Refs. 22 and 23.

education and contraception in the United States than in Western Europe and other regions of the world. Significant declines in adolescent pregnancy are primarily related to improved contraceptive patterns by adolescents (28).

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