Why Do Teenage Girls Give Birth to a More Not Healthy Baby

• Research article
• Open Access
• Published: 25 May 2016

Teenage pregnancy: the bear upon of maternal adolescent childbearing and older sister's teenage pregnancy on a younger sister

BMC Pregnancy and Childbirth volume xvi, Commodity number:120 (2016) Cite this article

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Abstract

Groundwork

Risk factors for teenage pregnancy are linked to many factors, including a family history of teenage pregnancy. This research examines whether a mother's teenage childbearing or an older sister'south teenage pregnancy more strongly predicts teenage pregnancy.

Methods

This report used linkable administrative databases housed at the Manitoba Centre for Health Policy (MCHP). The original cohort consisted of 17,115 women born in Manitoba between Apr ane, 1979 and March 31, 1994, who stayed in the province until at to the lowest degree their 20^th birthday, had at to the lowest degree i older sis, and had no missing values on key variables. Propensity score matching (one:2) was used to create balanced cohorts for two conditional logistic regression models; 1 examining the impact of an older sister'southward teenage pregnancy and the other analyzing the effect of the mother's teenage childbearing.

Results

The adapted odds of becoming pregnant between ages 14 and nineteen for teens with at least one older sis having a teenage pregnancy were iii.38 (99 % CI 2.77–4.thirteen) times higher than for women whose older sis(s) did not take a teenage pregnancy. Teenage daughters of mothers who had their offset child earlier age xx had 1.57 (99 % CI 1.30–i.89) times higher odds of pregnancy than those whose mothers had their showtime child later age 19. Educational achievement was adjusted for in a sub-population examining the odds of pregnancy betwixt ages 16 and 19. After this adjustment, the odds of teenage pregnancy for teens with at least 1 older sister who had a teenage pregnancy were reduced to 2.48 (99 % CI 2.01–3.06) and the odds of pregnancy for teen daughters of teenage mothers were reduced to one.39 (99 % CI 1.15–i.68).

Conclusion

Although both were significant, the relationship between an older sister's teenage pregnancy and a younger sister's teenage pregnancy is much stronger than that between a mother's teenage childbearing and a younger daughter's teenage pregnancy. This study contributes to understanding of the broader topic "who is influential well-nigh what" within the family.

Peer Review reports

Background

The risks and realities associated with teenage motherhood are well documented, with consequences starting at childbirth and following both female parent and child over the life span.

Teenage births issue in health consequences; children are more likely to be born pre-term, take lower birth weight, and higher neonatal mortality, while mothers feel greater rates of postal service-partum low and are less likely to initiate breastfeeding [1, 2]. Teenage mothers are less probable to complete loftier school, are more likely to live in poverty, and have children who oft experience health and developmental issues [3]. Understanding the risk factors for teenage pregnancy is a prerequisite for reducing rates of teenage motherhood. Diverse social and biological factors influence the odds of teenage pregnancy; these include exposure to adversity during babyhood and adolescence, a family history of teenage pregnancy, conduct and attention problems, family instability, and depression educational achievement [4, 5].

Mothers and older sisters are the master sources of family influence on teenage pregnancy; this is due to both social risk and social influence. Family members both contribute to an individual'southward attitudes and values around teenage pregnancy, and share social risks (such every bit poverty, ethnicity, and lack of opportunities) that influence the likelihood of teenage pregnancy [6, 7]. Having an older sister who was a teen mom significantly increases the gamble of teenage childbearing in the younger sister and daughters of teenage mothers were significantly more than likely to become teenage mothers themselves [viii, 9]. Girls having both a female parent and older sister who had teenage births experienced the highest odds of teenage pregnancy, with one written report reporting an odds ratio of 5.1 (compared with those who had no history of family unit teenage pregnancy) [v]. Studies consistently indicate that girls with a familial history of teenage childbearing are at much higher run a risk of teenage pregnancy and childbearing themselves, but methodological complexities have resulted in inconsistent findings around "parent/child sexual communication and adolescent pregnancy risk" [10]. A review of family relationships and adolescent pregnancy risk institute risk factors to include living in poor neighborhoods and families, having older siblings who were sexually active, and being a victim of sexual abuse [ten]. Research effectually the touch on of sister'south teenage pregnancy has been limited to mostly qualitative studies using pocket-size samples of minority adolescents in the United States [5, 11].

To our knowledge, no previous studies accept examined the touch of an older sister's teenage pregnancy on the odds of her younger sister having a teenage pregnancy, and compared this upshot with the straight effect of having a mother who bore her offset child earlier age 20. By controlling for a variety of social and biological factors (such as neighborhood socioeconomic status, marital status of female parent, residential mobility, family unit construction changes, and mental health), and the utilize of a strong statistical design—propensity score matching with a large population-based dataset—this report aims to make up one's mind whether teenage pregnancy is more strongly predicted by having an older sister who had a teenage pregnancy or by having a mother who bore her showtime kid earlier historic period 20.

Methods

Setting

The setting of this study, Manitoba, is generally representative of Canada as a whole, ranking in the middle for several health and education indicators [12, 13]. At the time of the 2011 Census, approximately 1.2 million people resided in Manitoba, with more than than one-half (783,247) living in the ii urban areas, Winnipeg and Brandon [fourteen]. Teenage pregnancy rates in Manitoba exceed the national; in 2010 teenage pregnancy rates in Canada were 28.2 per chiliad, in Manitoba the rate was 48.7 per 1000 [15]. The Manitoba teen pregnancy rates in 2010 were slightly lower than rates in England and Wales (54.6 per 1000), and the United States (57.4 per 1000) [sixteen, 17].

Information

The Manitoba Population Health Research Data Repository contains province-broad, routinely collected private data over fourth dimension (going back to 1970 in some files), beyond space (with residential location documented using six digit postal codes), for each family unit (with changes in family structure recorded every 6 months) and for each resident. Health variables are measured continuously from doc claims and infirmary abstracts (as long as an individual remains in Manitoba) [eighteen].

A inquiry registry identifies every provincial resident, with information on births, arrival and divergence dates, and deaths created from the provincial health registry and coordinated with Vital Statistics files. Given approximately 16,000 births annually, follow-up (about 74 % over 20 years) is comparable to that in the largest cohort studies based on primary data [19]. Previous research using similar information shows the results are not biased by individuals leaving the province or dying. Information on data linkage, confidentiality/privacy, and validity of the datasets used accept been described elsewhere [20–22]. Children are linked to mothers using hospital birth record information; the mother was noted in essentially all cases [23]. Sisters were defined as having the same biological mother.

The cohort consists of women who were born in Manitoba between April 1, 1979 and March 31, 1994, stayed in the province until at least their 20^th birthday, had at to the lowest degree ane older sister, and had no missing values on key variables. In this report, teenage pregnancies are defined equally those between the ages of fourteen and 19; pregnancies prior to age 14 were excluded due to low numbers and for comparability to other studies. For this reason, families in which at least one sister had a pregnancy before age 14 were removed (34 families). To address threats of independence, when a family had more than ane younger sister (more 2 daughters), one younger sister was randomly selected. Figure 1 diagrams the pick trajectory for the 17,115 individuals selected—boxes in assuming point the included cohort. At historic period 14, just over 85 % of girls in this cohort were living in the same postal code equally at least ane older sister.

Fig. 1

Cohort option

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Outcome

Teenage pregnancy was defined as having at to the lowest degree one pregnancy between the ages of 14 and 19 (inclusive). A pregnancy is defined as having at least one hospitalization of with a live birth, missed abortion, ectopic pregnancy, abortion, or intrauterine death, or at to the lowest degree one hospital procedure of surgical termination of pregnancy, surgical removal of ectopic pregnancy, pharmacological termination or pregnancy or intervention during labour and delivery. Pregnancy status was determined by ICD-ix-CM codes (for diagnoses before April i, 2004), ICD-10-CA codes (for diagnoses on or afterwards Apr one, 2004), and Canadian Nomenclature of Health Intervention (CCI) codes in the hospital discharge abstract database [24]. Appendix one presents specific codes used to determine pregnancy status.

Independent variable

The independent variables of involvement were whether an individual had an older sis with a teenage pregnancy (defined for all sisters every bit described in a higher place) and whether an individual'southward mother bore her beginning kid earlier age xx.

Covariates

Based on an extensive literature review and availability of data in the database, several primal variables describing neighborhood, maternal, and individual characteristics were included [4, 25]. Covariates measure out characteristics in the younger sister's life earlier age 14. Neighborhood socioeconomic status at historic period 14 was measured by the Socioeconomic Gene Index (SEFI) (higher SEFI score corresponds with lower socioeconomic status), which is generated using Manitoba (Statistics Canada) broadcasting areas [26]. This index combines neighborhood information on income, educational activity, employment, and family unit construction. These neighborhoods typically include betwixt 400 and 700 urban individuals and are somewhat larger in rural areas. Neighborhood location at age 14 was divided into urban (Winnipeg and Brandon), rural south (South Eastman, Central, and Assiniboine Regional Wellness Government), and rural mid/north (Due north Eastman, Interlake, Parkland, Nor-Human, Churchill, and Burntwood Regional Health Authorities). The maternal characteristic included is marital status at birth of child. An individual's number of older sisters was as well accounted for.

Three time-varying covariates between birth and age thirteen for the younger sister were included in the study- mental health conditions, residential mobility, and family unit structure change. These variables tin can occur at specific points in time and the timing of their occurrence can differ across individuals. Mental wellness is defined using the Johns Hopkins University Adjusted Clinical Grouping (ACG) software; this software groups medical and hospital diagnoses over the grade of a yr into 27 Major Expanded Diagnostic Clusters (MEDCs) [27]. If for i year between birth and age xiii, the diagnoses an individual received cruel into the 'Mental Health' MEDC, that individual was categorized as having mental health conditions before historic period thirteen. Residential mobility was measured by at least one residential move (divers by change in six digit postal code) betwixt birth and age thirteen. At least i change in family construction (parental divorce, death, wedlock, remarriage) between birth and age 13 was noted as 'family structure change'.

Depression educational achievement has been linked to an increased risk of teenage pregnancy [28]. The primeval measure of educational achievement available is the Form 9 Achievement Index, which was built on a technique developed by Mosteller and Tukey using enrollment files, course grades, and the provincial population registry [29, xxx]. Equally some of the individuals in this accomplice experience their first pregnancy before completing grade ix, this covariate is only appropriate for girls having their start pregnancy after their 16^th altogether. Sensitivity testing was done with this population to determine how strongly educational achievement affected the odds of the variables of interest.

Analytic approach

The relationship between pregnancy during 1'south teenage years and having an older sister who became pregnant during adolescence or having a mother who bore her kickoff child as a teenager is confounded by many measured and unmeasured characteristics. We adjusted for these confounding characteristics using two:1 propensity score matching [31]; two controls were matched with every case equally this "volition result in optimal interpretation of treatment result [32]". Propensity score matching both enables adjustment for several confounders simultaneously and facilitates diagnostic tests to identify whether the aligning strategy created comparable exposure groups (i.e., whether women with and without an older sister who got pregnant during adolescence are similar on observed characteristics) [31]. Logistic regression models were used to calculate propensity scores for two responses—the predicted probability of having an older sister having a teenage pregnancy and the predicted probability of having a mother bearing her first child earlier age xx. For each model, we investigated the comparability of our two groups—those with and without an older sister having a teenage pregnancy, and those with and without a female parent who bore her first child as a teenager—using two diagnostics. A kernel density plot verified that the distribution of propensity scores in our two groups overlapped [33]; each case was matched to two controls using greedy matching [34]. Second, after matching, the balance of the covariates was assessed using standard differences and t-tests. Covariate balance was checked by t-statistics calculated for the standardized differences between cases and controls for each covariate before and after matching. Any betoken outside of the two vertical dotted lines signified a statistically significant difference between the cases and controls on that covariate (at p = 0.05) (Figs. 2 and iii).

Fig. ii

Checking covariate remainder of older sister'southward teenage pregnancy condition

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Fig. 3

Checking covariate balance of female parent' teenage mom condition

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Provisional logistic regression analysis of the matched cohorts examined the touch on of an older sis's teenage pregnancy and of a mother's teenage childbearing on teenage pregnancy. Sensitivity assay helped appraise the validity of the assumption of no unobservable confounders, and assessed how strong the influence of unobserved covariates would have to be in guild to nullify our findings [35, 36]. The lower limit of the 99 % confidence interval (selected to be more conservative) was used to determine the threshold unobserved covariates would have to reach to void the observed relationship.

Results

Impact of older sister having a teenage pregnancy

Tabular array 1 displays the descriptive statistics of the covariates and outcome variables. Of the girls having an older sister with a teenage pregnancy, twoscore.4 % had a teenage pregnancy. This is significantly higher than the ten.3 % teenage pregnancy rate amidst those not having an older sister with a teenage pregnancy.

Table 1 Covariates and outcomes (older sister having a teenage pregnancy)

Full size table

The covariates, in general, accord with social stratification theory [37]. Teens with an older sis having a teenage pregnancy were likewise more probable to take been built-in to an single mother and accept a mother who herself was a teenage mother (43 % versus 14 %). At age 14, approximately 42 % of those whose older sister had a teenage pregnancy lived in Rural Mid/Northern Manitoba; simply 22 % of those whose older sister did not have a teenage pregnancy lived in this region at age fourteen. Lower teenage pregnancy was associated with residence in relatively prosperous southern Manitoba. Individuals with older sisters having teenage pregnancies were more than likely to alive in lower socioeconomic status neighborhood (higher SEFI scores at age 14) with higher rates of residential mobility (68 % vs 59 %), family structure change (28 % vs 16 %), and mental wellness issues (19 % vs sixteen %).

After propensity score matching (on all variables in Fig. 2), the terminal sample consisted of 1873 cases and 3746 controls (1:2); a full of 1618 cases and 9878 controls were excluded from the analysis. T-statistics calculated for each covariate before and afterward matching to bank check for covariate balance; all covariates differed significantly in the unmatched sample and balanced in the matched sample (Fig. 2).

The terminal conditional logistic regression model indicates the odds of becoming pregnant before age twenty for those having an older sister with a teenage pregnancy to exist 3.38 (99 % CI two.77–4.13) times greater than for girls whose older sis(s) did not have a teenage pregnancy (Tabular array 3).

Impact of mother's teenage childbearing

Table 2 displays the descriptive statistics of the covariates and outcome variables. Of the girls having a teenage mother, 39.four % had a teenage pregnancy. This is significantly higher than the xiii.1 % teenage pregnancy rates among those whose mother diameter her first child after historic period 19.

Table 2 Covariates and outcomes (female parent'due south teenage childbearing)

Full size tabular array

After propensity score matching (on all variables in Fig. three), the final sample consisted of 1522 cases and 3044 controls (1:2); a total of 659 cases and 11890 controls were excluded from the analysis. T-statistics calculated for each covariate showed all covariates to differ significantly in the unmatched sample and to residuum in the matched sample (Fig. 3).

The last provisional logistic regression model indicates that the odds of becoming pregnant before age 20 for those whose mother had her first kid earlier age 20 are 1.57 (99 % CI 1.thirty–1.89) times greater than for girls whose mother had her first child after age nineteen (Table iii). Thus, the impact of being born to a mother having her commencement kid before age 20 on teenage pregnancy is much less than that of an older sisters' teenage pregnancy.

Table 3 Odds ratios for original and additional analyses

Full size table

Sensitivity analysis and limitations

With the confidence interval for the first model (examining the association between an older sister'south teenage pregnancy and a younger sister's teenage pregnancy) ranging between 2.77 and 4.thirteen, to attribute the higher rates of teenage pregnancy to unmeasured confounding rather than to an older sisters' teen pregnancy status, that covariate would need to generate more than than a two.8-fold increase in the odds of teenage pregnancy and be a near perfect predictor of teenage pregnancy. In the second model (assessing the association between a mother's teenage childbearing and a younger sister's teenage pregnancy), the 99 % conviction interval was 1.xxx to 1.89; unobserved covariates would demand to produce a much smaller increment in odds of teen pregnancy to nullify this finding.

Although linkable administrative data have significant advantages, some of import predictors are lacking. Data on involvement with Child and Family Services (CFS) and parental utilize of income assistance have recently been added to the Manitoba databases, only do non encompass the cohort used here. While having a teenage female parent and becoming a teenage mother have both been linked to interest with CFS, in 2001 less than two percent of children under age 18 were in care [38, 39]. A variable available (and applicable) for a subpopulation is educational achievement, which is highly correlated with both interest with CFS and parental welfare use [twoscore]. These 2 new measures would probable explicate little additional variance in teenage pregnancy. Appendix 2 describes the cohort and propensity score matching for this boosted analysis, comparison these findings with the original results in Table iii. Educational attainment is measured using the Class ix Achievement Index, a standardized mensurate taking into account the number of courses completed in Grade 9 and the average marks of those courses. Later on adjusting for educational achievement, the odds of teenage pregnancy for teens with at least one older sister who had a teenage pregnancy were reduced to ii.48 (99 % CI two.01–3.06) and the corresponding odds for teen daughters of teenage mothers were lowered to i.39 (99 % CI 1.fifteen–1.68).

Give-and-take

The rate differences of teenage pregnancy were similar for those whose older sis had a teenage pregnancy (twoscore.iv per 100 - ten.three per 100 = xxx.ane per 100) and for those whose female parent bore her first child before age twenty (39.iv per 100 - 13.1 per 100 = 26.3 per 100). Afterward propensity score matching on a serial of variables, the odds of becoming significant for a teenager were much higher if her older sister had a teenage pregnancy than if her mother had been a teenage female parent. For both older sisters' teenage pregnancy and mother'due south teenage childbearing, the odds in this written report are lower than those reported elsewhere; this is likely due to the larger sample size, more rigorous methods, and inclusion of important predictors.

Several examinations of family unit histories in the literature show older sisters to accept the greatest influence on a younger sis'southward odds of having a teenage pregnancy. Controlling for family socioeconomic status, maternal parenting, and sibling relationships, teens with an older sister who had a teenage birth were iv.eight times more than likely to have a teenage nativity themselves; these odds increased to 5.i if both the older sister and mother had a teenage birth [11]. Four older studies estimated the charge per unit of teen pregnancy to be between 2 and 6 times higher for those with older sisters having a teenage pregnancy [41]. This work focused primarily on young black women in the United States and controlled for express confounders (aside from race and age). None of the previous studies examining the touch of an older sister'southward teenage pregnancy controlled for mother's teenage childbearing or time-varying factors before age 14 (mental wellness, residential mobility, family construction changes); this research probably overestimated the relationship betwixt sisters' teenage pregnancy status.

The mechanisms driving the human relationship between an older sister's teenage pregnancy and the pregnancy of a younger adolescent sister have been examined through approaches based on social learning theory, shared parenting influences, and shared societal risk [41]. Bandura's social learning theory indicates that "most human behavior is learned observationally through modeling: from observing others one forms an thought of how new behaviors are performed, and on afterwards occasions this coded information serves equally a guide for activity" [seven]. When sisters live in the aforementioned surround, seeing an older sister go through a teenage pregnancy and childbirth may make this a more acceptable selection for the younger sis [xi]. Not simply practice both sisters have the aforementioned maternal influence that may affect their odds of teenage pregnancy, having an older sister who is a teenage mother may modify the parenting way of the mother. Mothers involved in parenting of their teenage daughters' kid may have "supervised their children less, communicated with their children less about sex and contraception, and perceived teenage sex as more than acceptable when the older daughter's status changed from pregnant to parenting" [42]. Finally, both sisters share the aforementioned social risks, such equally poverty, ethnicity, and lack of opportunities, that increase their chances of having a teenage pregnancy [42].

Having a mother bearing her first kid before age twenty was a pregnant predictor for teenage pregnancy. We found daughters of teenage mothers to be 51 % more probable to have a teenage pregnancy than those whose mothers were older than xix when they bore their first child. This is quite close to the 66 % increment found by Meade et al (2008), who controlled for many of the same variables except having an older sis with a teenage pregnancy, and the time-varying covariates of family unit structure modify, mental health conditions, and residential mobility. Meade et al. [9] did conform for school performance; in the adapted sub-sample, the odds ratio reduced to 1.34, indicating a 34 % increase in teenage pregnancy.

Intergenerational teenage pregnancy may be influenced by such mechanisms every bit "biological heritability, intergenerational transmission of values regarding family, the female parent's level of fertility, the indirect affect of socioeconomic and family unit surround through educational deficits or low opportunity or aspirations, and directly through the mother's office modeling" [43]. Women bearing their first child in their adolescence are more probable to pass on "risky" characteristics, which could produce negative outcomes in their offspring [44]. Another mechanism identified equally contributing to intergenerational teenage pregnancy is that daughters of teenage mothers have an increased internalized preference for early motherhood, have depression levels of maternal monitoring, and are thus more probable to go sexually active at a young historic period and engage in unprotected sex [44]. The influence of a mother'southward teenage pregnancy therefore works through the surroundings created and parenting style assumed as a effect of a mother's teenage childbearing.

The utilize of administrative data to conduct health services inquiry has some significant advantages and limitations. Authoritative data from a large birth accomplice have higher levels of accurateness is non depending on recall (such as in retrospective surveys) and is ideal for examining risk factors over time due to the longitudinal follow-up [45]. These data—with a large N and a number of covariates—are well-suited for propensity scoring. A meaning limitation (shared with almost all observational studies) is that certain covariates and mediating effects are unobservable due to lack of information. The data tin simply capture recorded variables; for instance, merely individuals seeking mental health treatment will receive a diagnosis, which may not exist include all individuals with mental health atmospheric condition [46]. Sensitivity testing addresses this limitation, but such covariates might well have impacted study results. As mentioned to a higher place, not adjusting for involvement with child protective services (such equally CFS) is a limitation. Although the number of teenage girls involved with CFS is relatively modest, they may non be interacting with their mother or older sister on a regular basis and thus are less likely to model themselves after their family members. The availability of an educational predictor was an identified limitation. To account for the touch on of educational achievement in our full cohort, educational outcomes would need to be bachelor for everyone for grade 7 at the latest (every bit almost all teenage pregnancies occur after grade 7). Since educational accomplishment by and large remains quite like from year to year—class 9 accomplishment is likely to be quite similar to grade 7 accomplishment [30]; this reduced odds ratio may meliorate estimate the true odds. In several years, such variables tin exist incorporated into models of teenage pregnancy. Additionally, we were unable to identify Aboriginal individuals; this is a limitation as teenage pregnancy rates are more than twice as loftier in the Aboriginal population than in the full general population [47]. Family and peer relationships, social norms, and cultural differences volition likely never be measured through administrative data; limiting the caste to which these confounders can exist controlled for.

Conclusions

This paper contributes to understanding of the broader topic "who is influential about what" within the family. The teenage pregnancy risk seen in younger sisters when older sisters had a teenage pregnancy appears based on the interaction with that sister and her child; the family unit environment experienced by the siblings is quite similar. Much of the pregnancy risk amid teenage daughters of mothers bearing a kid before historic period 20 seems likely to upshot from the adverse environment often associated with early childbearing. Given that an older sister's teenage pregnancy has a greater impact than a mother'southward teenage childbearing, social modelling may exist a stronger run a risk factor for teenage pregnancy than living in an adverse environment.

Abbreviations

ACG:

Adapted Clinical Group

CCI:

Canadian Classification of Health Intervention

CFS:

Kid and Family Services

ICD-9-CM:

International Classification of Diseases, Ninth Revision, Clinical Modification

ICD-x-CA:

International Classification of Diseases, tenth Revision, with Canadian Enhancements

MEDC:

Major Expanded Diagnostic Clusters

MCHP:

Manitoba Centre for Wellness Policy

SEFI:

Socioeconomic Cistron Index

References

1. Chen XK, Wen SW, Fleming N, Demissie M, Rhoads GG, Walker 1000. Teenage pregnancy and agin birth outcomes: a big population based retrospective accomplice study. Int J Epidemiol. 2007;36:368–73.

   CAS  Article  PubMed  Google Scholar

2. Kingston D, Heaman Thousand, Fell D, Chalmers B. Comparing of adolescent, young developed, and developed women's maternity experiences and practices. Pediatrics. 2012;129:e1228–37.

   Article  PubMed  Google Scholar

3. Hoffman SD, Maynard R. Kids Having Kids: Economic Costs & Social Consequences of Teen Pregnancy. Washington, DC: The Urban Constitute Press; 2008.

   Google Scholar

4. Woodward L, Fergusson DM, Horwood LJ. Risk factors and life processes associated with teenage pregnancy: Results of a prospective written report from birth to xx years. J Wedlock Fam. 2001;63:1170–84.

   Commodity  Google Scholar

5. East P, Reyes B, Horn Due east. Association between boyish pregnancy and a family unit history of teenage births. Perspect Sex Reprod Health. 2007;39:108–fifteen.

   Article  PubMed  PubMed Primal  Google Scholar

6. Akella D, Jordan M. Affect of social and cultural factors on teen pregnancy. J Health Dispar Res Pract. 2011;8:41–62.

   Google Scholar

7. Bandura A. Social learning theory. New York: General Learning Press; 1977.

   Google Scholar

8. Ferraro AA, Cardoso VC, Barbosa AP, Da Silva AAM, Faria CA, De Ribeiro VS, Bettiol H, Barbieri MA. Childbearing in adolescence: intergenerational dejà-vu? Prove from a Brazilian birth accomplice. BMC Pregnancy Childbirth. 2013;thirteen:149.

   Article  PubMed  PubMed Central  Google Scholar

9. Meade CS, Kershaw TS, Ickovics JR. The intergenerational cycle of teenage motherhood: an ecological approach. Wellness Psychol. 2008;27:419–29.

   Article  PubMed  Google Scholar

10. Miller B, Benson B. Family unit relationships and adolescent pregnancy risk: A research synthesis. Dev Rev. 2001;21:one–38.

    CAS  Article  Google Scholar

11. Due east PL, Slonim A, Horn EJ, Trinh C, Reyes BT. How an adolescent's childbearing affects siblings' pregnancy adventure: a qualitative study of Mexican American youths. Perspect Sex Reprod Health. 2009;41:210–7.

    Article  PubMed  PubMed Fundamental  Google Scholar

12. Oreopoulos P, Stabile Grand, Walld R, Roos L. Short, medium, and long term consequences of poor babe health: An analysis using siblings and twins. J Hum Resour. 2008;43:88–138.

    Article  Google Scholar

13. Shanahan M, Gousseau C. Using the POPULIS framework for interprovincial comparing of expenditures on health care. Med Care. 1999;37:JS83–JS100.

    CAS  Article  PubMed  Google Scholar

14. Statistics Canada. Focus on geography serial, 2011 census. 2014.

    Google Scholar

15. McKay A. Trends in Canadian National and Provincial/Territorial teen pregnancy rates: 2001-2010. Can J Hum Sex. 2012;21:161–75.

    Google Scholar

16. Role of National Statistics. Conceptions in England and Wales, 2010. Newport, CN: Office for National Statistics; 2012.

    Google Scholar

17. Kost K, Henshaw S. U.S. teenage pregnancies, births and abortions. 2014.

    Google Scholar

18. Nickel N, Chateau D, Martens P, Brownell K, Katz A, Burland Eastward, Walld R, Hu M, Taylor C, Sarkar J, Goh C, Team TPE. Data resource contour: Pathways to health and social equity for children (PATHS Equity for Children). Int J Epidemiol. 2014;43:1438–49.

    Article  PubMed  PubMed Central  Google Scholar

19. Power C, Kuh D, Morton Due south. From developmental origins of adult disease to life grade inquiry on adult disease and crumbling: Insights from nativity cohort studies. Annu Rev Public Health. 2013;34:seven–28.

    Article  PubMed  Google Scholar

20. Ladouceur M, Leslie Due west, Dastani Z, Goltzman D, Richards J. An efficient paradigm for genetic epidemiology cohort creation. PLoS One. 2010;5:e14045.

    Article  PubMed  PubMed Cardinal  Google Scholar

21. Roos L, Gupta S, Soodeen R, Jebamani R. Data quality in an data-rich environment: Canada as an case. Can J Aging. 2005;24:153–lxx.

    Commodity  PubMed  Google Scholar

22. Roos L, Nicol J. A inquiry registry: Uses, evolution, and accuracy. J Clin Epidemiol. 1999;52:39–47.

    CAS  Article  PubMed  Google Scholar

23. Currie J, Stabile Grand, Manivong P, Roos L. Child health and young adult outcomes. J Hum Resour. 2010;45:517–48.

    Article  Google Scholar

24. Concept: Teenage pregnancy [http://mchp-appserv.cpe.umanitoba.ca/viewConcept.php?conceptID=1248].

25. McCall SJ, Bhattacharya S, Okpo E, Macfarlane Grand. Evaluating the social determinants of teenage pregnancy: A temporal analysis using a Britain obstretics database from 1950 to 2010. J Epidemiol Community Wellness. 2015;69:49–54.

    Article  PubMed  Google Scholar

26. Chateau D, Metge C, Prior H, Soodeen R. Learning from the census: The socio-economical factor index (SEFI) and wellness outcomes in Manitoba. Can J Public Heal. 2012;103 Suppl two:S23–7.

    Google Scholar

27. The Johns Hopkins University. The Johns Hopkins ACG instance-mix arrangement (Version half dozen.0 Release Notes). 2003.

    Google Scholar

28. Manlove J. The influence of loftier school dropout and school detachment on the risk of school-age pregnancy. J Res Adolesc. 1998;viii:187–220.

    CAS  Commodity  PubMed  Google Scholar

29. Mosteller F, Tukey J. Data analysis and regression: a 2nd class in statistics. Reading: Addison-Wesley; 1977.

    Google Scholar

30. Roos L, Hiebert B, Manivong P, Edgerton J, Walld R, MacWilliam L, de Rocquigny J. What is well-nigh important: Social factors, health selection, and adolescent educational achievement. Soc Indic Res. 2013;110:385–414.

    Article  Google Scholar

31. Rosenbaum P, Rubin D. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983;70:41–55.

    Article  Google Scholar

32. Austin PC. Statistical criteria for selecting the optimal number of untreated subjects matched to each treated subject area when using many-to-i matching on the propensity score. Am J Epidemiol. 2010;172:1092–vii.

    Article  PubMed  PubMed Primal  Google Scholar

33. Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivar Behav Res. 2011;46:399–424.

    Commodity  Google Scholar

34. Parsons LS. Reducing Bias in a Propensity Score Matched-Pair Sample Using Greedy Matching Techniques. Cary, NC: Ovation Research Group; 2001.

    Google Scholar

35. Jiang M, Foster M, Gibson-Davis C. Breastfeeding and child cerebral outcomes: A propensity score matching approach. Matern Child Health J. 2011;15:1296–307.

    Article  PubMed  Google Scholar

36. Rosenbaum P. Observational studies. New York: Springer; 1995.

    Volume  Google Scholar

37. Singh Due south, Darroch JE, Frost JJ, the Study Team. Socioeconomic disadvantage and adolescent women's sexual and reproductive behaviour: The example of five developed countries. Fam Plann Perspect. 2001;33:251–89.

    CAS  Article  PubMed  Google Scholar

38. Jutte D, Roos N, Brownell M, Briggs Thou, MacWilliam L, Roos L. The ripples of adolescent motherhood: Social, educational and medical outcomes for children of teen and prior teen moms. Acad Pediatr. 2010;ten:293–301.

    Commodity  PubMed  Google Scholar

39. Kusch L: Number of kids in intendance soars to all-time loftier. Winnipeg Free Press. Retrieved from http://www.winnipegfreepress.com/local/number-of-kids-in-care-soars-to-best-high-278761011.html. 2014.

40. Brownell Grand, Roos NP, MacWilliam L, Leclair L, Ekuma O, Fransoo R. Academic and social outcomes for high-risk youths in Manitoba. Can J Educ. 2010;33:804–36.

    Google Scholar

41. E P, Felice 1000. Pregnancy risk among the younger sisters of pregnant and childbearing adolescents. J Dev Behav Pediatr. 1992;13:128–36.

    CAS  Article  PubMed  Google Scholar

42. East PL. The first teenage pregnancy in the family: Does information technology affect mothers' parenting, attitutes, or mother-boyish communication? J Marriage Fa. 1999;61:306–19.

    Article  Google Scholar

43. Kahn JR, Anderson Thousand. Intergenerational patterns of teenage fertility. Demography. 1992;29:39–57.

    CAS  Article  PubMed  Google Scholar

44. Jaffee S, Caspi A, Moffitt TE. Why are children born to teen mothers at run a risk for agin outcomes in immature adulthood? Results from a twenty-yr longitudinal study. Dev Psychopathol. 2001;13:377–397.

    CAS  Commodity  PubMed  Google Scholar

45. Jutte D, Roos L, Brownell G. Administrative record linkage as a tool for public health research. Annu Rev Public Wellness. 2011;32:91–108.

    Commodity  PubMed  Google Scholar

46. Bolton J, Au W, Walld R, Chateau D, Martens P, Leslie W, Enns G, Sareen J. Parental bereavement after the death of an offspring in a motor vehicle collision: A population-based study. Am J Epidemiol. 2013;179:177–85.

    Commodity  PubMed  Google Scholar

47. Murdoch 50. Young Aboriginal Mothers in Winnipeg. Winnipeg, MB: Prairie Women's Wellness Centre of Excellence; 2009.

    Google Scholar

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Acknowledgements

The results and conclusions are those of the authors and no official endorsement by the Manitoba Heart for Health Policy, Manitoba Health, Active Living and Seniors, or other data providers is intended or should exist inferred. Data used in this written report are from the Population Health Research Data Repository housed at the Manitoba Center for Health Policy, University of Manitoba and were derived from data provided past Manitoba Health, Active Living and Seniors and Manitoba Education under projection #2013/2014-04. All data direction, programming and analyses were performed using SAS® version 9.three. Aggregated Diagnosis Groups™(ADGs®) codes were created using The Johns Hopkins Adjusted Clinical Group® (ACG®) Example-Mix System" version nine.

Funding

This research has been supported by the Canadian Plant for Advanced Inquiry and the Western Regional Training Centre. The funding sources had no involvement in study design, assay and interpretation of information, in writing the article, and in the determination to submit for publication. None of the authors received whatever reimbursement for participating in the writing of this newspaper.

Availability of data and materials

The datasets supporting the conclusions of this article are available in the research repository at the Manitoba Centre for Health Policy. Admission to data is given upon approvals from the University of Manitoba Health Research Ethics Board and the Health Information Privacy Commission, and permission from all data providers. More than information on admission to these databases can exist plant at http://umanitoba.ca/faculties/health_sciences/medicine/units/community_health_sciences/departmental_units/mchp/resources/access.html.

Authors' contributions

EW participated in the design of the study, carried out the analysis and drafted the manuscript. LR conceived of the report, and participated in its blueprint and coordination and helped to typhoon the manuscript. NN participated in its design and interpretation of results. All authors read and approved the last manuscript.

Authors' information

EW is a PhD candidate in the Department of Community Wellness Sciences at the University of Manitoba. LLR is a Distinguished Professor in the Faculty of Health Sciences at the University of Manitoba and a founding director of the Manitoba Centre for Wellness Policy. NCN is a Research Scientist at the Manitoba Heart for Health Policy and an Assistant Professor in the Department of Community Health Sciences at the University of Manitoba.

Competing interests

The authors declare that they have no competing interests.

Consent for publication

Non Applicable.

Ideals approval and consent to participate

This study involved secondary analysis of de-identified data files merely, with linkages to other files where identifiers accept been removed or scrambled. Consent was non obtained from study subjects, equally permitted nether section 24(3)c of the Personal Health Information Act. Ideals approvals for this project were obtained from the University of Manitoba Health Research Ethics Board (reference number 2013-033) and the Health Data Privacy Commission (reference number 2013/2014-04).

Author information

Affiliations

1. Manitoba Centre for Wellness Policy, Section of Community Health Sciences, Kinesthesia of Health Sciences, College of Medicine, University of Manitoba, 408-727 McDermot Avenue, Winnipeg, Manitoba, R3E 3P5, Canada

   Elizabeth Wall-Wieler, Leslie L. Roos & Nathan C. Nickel

Respective author

Correspondence to Elizabeth Wall-Wieler.

Appendix i

Pregnancy diagnosis codes

Teenage pregnancy is defined as females with a hospitalization with one of the following diagnoses (MCHP, 2013):

• ○ live birth: ICD-nine-CM code V27, ICD-10-CA lawmaking Z37

• ○ missed abortion: ICD-9-CM code 632, ICD-10-CA code O02.1

• ○ ectopic pregnancy: ICD-9-CM lawmaking 633, ICD-10-CA code O00

• ○ abortion: ICD-9-CM codes 634-637 ICD-10-CA codes O03-O07; or

• ○ intrauterine death: ICD-9-CM lawmaking 656.4, ICD-ten-CA lawmaking O36.iv

Or, a hospitalization with one of the post-obit procedures:

• ○ surgical termination of pregnancy: ICD-9-CM codes 69.01, 69.51, 74.91; CCI codes v.CA.89, five.CA.ninety

• ○ surgical removal of extrauterine (ectopic) pregnancy: ICD-9-CM codes 66.62, 74.3; CCI code 5.CA.93

• ○ pharmacological termination of pregnancy: ICD-9-CM code 75.0; CCI code five.CA.88; or

• ○ interventions during labour and delivery, CCI codes 5.Doctor.v, 5.MD.sixty

Appendix 2

Adjustment for educational achievement

Tabular array 4 Covariates and outcomes for older sis'south teenage pregnancy condition model

Full size table

Older sister'south teenage pregnancy status

Fig. 5

Checking covariate remainder of older sister'south teenage pregnancy status

Tabular array five Covariates and outcomes for mother'south teenage childbearing model

Total size table

Mother'south teenage childbearing condition

Fig. half-dozen

Checking covariate balance of mother' teenage mom status

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Wall-Wieler, E., Roos, L.L. & Nickel, N.C. Teenage pregnancy: the affect of maternal adolescent childbearing and older sister'southward teenage pregnancy on a younger sis. BMC Pregnancy Childbirth sixteen, 120 (2016). https://doi.org/x.1186/s12884-016-0911-ii

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• Received: twenty January 2016

• Accepted: fourteen May 2016

• Published: 25 May 2016

• DOI : https://doi.org/x.1186/s12884-016-0911-ii

Keywords

• Teenage pregnancy
• Familial influence
• Social modelling
• Intergenerational effects
• Linkable administrative data

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