Social Disparities in the Relationship Between Depression and Unintended Pregnancy During Adolescence and Young Adulthood

• Published in: Journal of adolescent health Vol. 60; no. 6; pp. 688 - 697
• Main Authors: Hall, Kelli Stidham, Ph.D., M.S, Richards, Jennifer L., M.P.H, Harris, Kathleen Mullan, Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2017; Elsevier BV
• Subjects: Adolescent; Adolescents; Adult; Confidence intervals; Continental Population Groups; Depression; Depression - ethnology; Depression - psychology; Ethnic Groups; Ethnicity; Female; Health disparities; Health Surveys; Humans; Mental depression; Minority groups; Pediatrics; Pregnancy; Pregnancy, Unplanned - ethnology; Pregnancy, Unplanned - psychology; Public health; Race; Race/ethnicity; Reproductive health; Reproductive Health - ethnology; Risk factors; Social Class; Social disparities; Socioeconomic status; Teenage pregnancy; Teenagers; Time Factors; Unintended pregnancy; United States; Unwanted pregnancy; Womens health; Young Adult; Young adults; United States > US; Reproductive health; Depression; Socioeconomic status; Race/ethnicity; Unintended pregnancy; Social disparities
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2016.12.003

Abstract Purpose We investigated the influence of depression on subsequent risk of unintended pregnancy and social disparities within this relationship, during adolescence and young adulthood. Methods Drawing upon 15-year, nationally representative data from 8,810 young U.S. women in the National Longitudinal Study of Adolescent to Adult Health, we estimated associations between depression and time to first pregnancies reported as unintended, overall and stratified by race/ethnicity, socioeconomic status, and age with Cox proportional hazard models. Results Moderate/severe depression symptoms were associated with an increased risk of unintended first pregnancy (hazard ratio [HR], 1.21; confidence interval [CI], 1.02–1.44). In stratified models, depression increased the pregnancy risk for all minority groups (HRs, 1.36–3.25) but not white women. Depression increased the pregnancy risk for women with $0–$19,999 (HR, 1.48; CI, 1.11–1.98) and $20,000–$49,999 (HR, 1.33; CI, 1.05–1.68) income levels but not those at higher levels. Depression increased the pregnancy risk for adolescents <20 years (HR, 1.35; CI, 1.07–1.71) but decreased the risk for women >24 years (HR, .47; CI, .25–.86). Conclusions Findings may inform more equitable, holistic public health strategies that target depression as a modifiable risk factor for adverse reproductive outcomes during adolescence and young adulthood.