Women who became pregnant in their teens are at higher risk for early death than women who did not, according to a study published March 4 in JAMA Network Open. Researchers analyzed the association between teen pregnancy and early death in a sample of 2.2 million Canadian women. They found that, compared to those without a teen pregnancy, women who had one pregnancy in their teens were 1.5 times as likely to die before age 31 and 2.1 times as likely if they had two or more pregnancies in their teens. Women whose pregnancy ended in a live birth, stillbirth, miscarriage, or ectopic pregnancy had a higher risk of early death than those whose pregnancy ended in an induced abortion (2.1 versus 1.4, respectively).

There is strong evidence that exposure to adverse childhood experiences (ACEs), such as violence, the presence of substance abuse or mental health problems, and sexual or physical abuse, increases both the risk of teen pregnancy and the risk of early death. It is likely that these ACEs, not the pregnancy itself, contribute to early death, according to the study authors.

Although teen birth rates in the United States have steadily fallen since 2009, reaching a historic low of 13.9% in 2021, according to the National Center for Health Statistics, significant disparities exist, with higher rates among American Indian/Alaska Native (24.2), Native Hawaiian/Other Pacific Islander (21.9), Hispanic (21.1), and Black (21.8) teens. The Department of Health and Human Services' Office of Population Affairs attributes these disparities to “inequities in access to family planning services and information; differences in attitudes about contraception, teen pregnancy, and teen childbearing; and distrust of medical professionals.”

Reducing the risk of teen pregnancy requires attending to underlying social determinants and boosting protective factors, which the study authors list as “a stable family, school and peer support, open communication with adult mentors or parents about contraception use, free access to contraception, and female empowerment to abstain from unwanted or unplanned intercourse.”