Risk of premature death among teenage mothers in England & Wales

Roger Webb and Kathryn Abel, University of Manchester

[Project number 30078]

The aim of this project is to estimate long term risks of premature mortality among women who first become mothers as teenagers: i.e. deaths from all causes, all unnatural causes and all natural causes. Using Poisson regression models, we will firstly estimate relative risks adjusted for time-period cohort effects vs. two general population reference groups:
(i) Women who become first-time mothers at age 20-29 years;
(ii) Women who are not mothers, matched on current age.
A secondary set of analyses will comprehensively adjust for socioeconomic status according to time-dependent national Census variables (1971, 1981, 1991 & 2001).

A key research theme at the Centre for Women's Mental Health is psychiatric and mortality outcomes among vulnerable families. To date we have conducted studies of mortality risk in children of mentally ill parents (Webb et al., 2007; King-Hele et al., in press) and the effects of exposure to stress during pregnancy on risk of psychopathology in adult offspring (Khashan et al., in press). We are now developing a new programme to investigate teenage childbearing in different European countries. We will utilise Scandinavian national psychiatric registers to address many of our research questions because these are unavailable in the UK, but where possible we plan to replicate key findings using British dataa)

Background literature:
The UK has the highest rate of teenage childbearing in Western Europe (Moffitt et al., 2002). A spectrum of ill effects has been linked with teenage motherhood, including poor reproductive outcomes (Fraser et al., 1995; Otterblad-Olausson et al., 1999), psychological distress (Maughan & Lindelow, 1997; Tan et al., 2006) and long-term socioeconomic disadvantage (Hobcraft & Kiernan, 2001; Robson & Berthoud, 2003). Data from the ONS Longitudinal Study showed elevated all-cause mortality risk at 50-69 years among women who first became mothers as teenagers (Grundy & Tomassini, 2005). There is, however, a lack of evidence for cause-specific mortality risks (especially from unnatural causes) and for death during younger adulthood. The only evidence comes from a Swedish study (Otterblad-Olausson et al., 2004), which followed up national cohort of teenage mothers (N>60,000). Elevated risks were seen for death by cervical cancer, heart disease, suicide and homicide, but follow up was for only five years (1991-1995). These results may not generalise well to the UK because Sweden has a far lower rate of teenage childbearing. Estimates of cause-specific mortality risk are therefore needed for the UK to inform the development of preventive strategies.

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