Patel, P., & Sen, B. (2012). Ten motherhood and long-term health consequences. Matern Child Health J,16(5), 1063-1071. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21656056
In this article, the researchers, Patel and Sen, have tried to ascertain the association between teen motherhood and the long-term physical (PCS) and mental (MCS) health outcomes. They have used the physical and mental components of SF-12 Healthy Survey in the NLSY79 health module to evaluate the health outcomes of teenage mothers. Various other parameters such as familial, demographic and environmental have been used as comparison as well. The teen mothers have also been compared with two groups: those who experienced teen-pregnancy only and those who had unsafe sex, but didn’t experience pregnancy. They used multivariate ordinal least square regression as an analytical tool. They found that the teen mothers fared poorly in health parameters in later years of their life. That is in comparison to all women in general, and as well as the comparison groups. A slight variation was found when they were compared to comparison group, where their PCS wasn’t statistically difference but MCS was.
The article is against the background that it cost significant amount of money to taxpayers to support teen mothers. In addition, they themselves exhibit poorer educational and economic outcomes. As researchers felt as little work has been done on this issue so far, they have explored the relationship between teen-motherhood and their mid-life health outcomes.
The researchers used National Longitudinal Survey of Youth 1979 (NLSY79), which is a sample of young people aged 14-22 years on the day of the first survey. These respondents were interviewed annually from 1979 to 1994. In this study, they used the physical (PCS) and mental (MCS) health components of the SF-12 Health Survey in the NLSY79 Health module. The PCS and MCS were designed such that the representative US population mean score was 50, and the standard deviation was 10. That implies that a one-point difference above or below 50 corresponds to one-tenth of standard deviation
The research used an analytical approach where sample participants of 4271 female respondents were chosen who’s PCS and MCS were reported in 2006. Their group of interest were those women who had a live birth while as a teenager. In comparing them with other women they tried to find the underlying confounders that can predict both teen-motherhood and future health outcomes. To do that they created to comparison groups: women who became pregnant as teenagers but then experienced miscarriage, abortion, or stillbirth; and women who reported to have had unprotected sex, but didn’t experience teen-pregnancy. Also, they defined a teenager as a person who is age of 18 or less. This is a fair test of the validity.
The regression 1 results show that teen mothers have lower PCS (b = -2.095, P < 0.001) and lower MCS (b = -1.336, P < 0.001) scores compared to all other women. According to regression 2, when other demographic, familial and other background were controlled, the estimated reduction in PCS (b = -1.596, P < 0.01) and MCS (b = -0.903, P < 0.01) for teen mothers compared to all other women are smaller, but still highly significant. The results of regression 3 show that, compared to omitted-category, teen mothers have significantly lower PCS (b = -1.590, P < 0.01) and MCS (b = -1.065, P < 0.01)
The researchers feel that this study is unique in the sense that it examines whether teen-motherhood has long term consequences on women’s physical and mental health later in life. They found significant negative association between teen-motherhood and women’s physical and mental health in their 40s.
Their research strongly suggests that teen mothers do have poorer physical health later in life. However, why it happens is beyond the limits of the study. Their presumption is that the underlying economic consequences as well as stress of childbearing at a young age leave them with fewer resources to invest in their own healthcare. The take away for policy makers is that resources allocated towards reducing teenage motherhood might go a long way in healthcare cost savings in future.
The results regarding the mental health (MCS) are more challenging. Both the teen-mothers and teen pregnancy not resulting in live births have similar and statistically similar negative association with mental health (MCS) later in life. This indicates that is not just teen-motherhood, but broadly teen-pregnancy that results in negative mental outcomes later in life. It may even reflect that factors leading to teen pregnancy that lead to worse mental health outcomes. Also, the experience of teen pregnancy in itself may have a negative influence, and those resulting in non-live birth may have even worse outcomes.
However, the authors acknowledge several shortcomings and limitations of the study. They express concern regarding the accuracy of self-reported data. Also they admit that they don’t have information about other social factors that may predict teen pregnancy. They also didn’t have access to information regarding health insurance status and access to pre-natal care.
Finally, they feel there is a good reason to believe that teen-mothers and the other two comparison groups are not identical in terms of unmeasured confounders. They feel that there may be other unmeasured confounders, even with the physical health outcomes. They advise caution in deriving any “causal” relationship. And recommend that more research needs to be done on the long-term effects.