All ETDs from UAB

School

School of Public Health

Document Type

Dissertation

Department (new version)

Public Health

Date of Award

1999

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

Despite efforts to reduce the incidence of adolescent pregnancy and childbearing in the U.S., it remains a pressing social concern and public health problem. Indeed, births to women under 20 continue to constitute one of every seven births in this country and remain higher than teen birth rates in comparable industrialized nations. The literature clearly indicates that factors such as (a) early initiation of sexual activity, (b) lack of appropriate reproductive knowledge, (c) limited educational aspirations, (d) low self-esteem, and (e) family poverty increase the likelihood that an adolescent will begin early childbearing and that she will subsequently have at least one additional birth during adolescence. It is also clear that a certain level of cognitive ability and decision-making competence are necessary for a young woman to negotiate critical decision points in order to avoid unplanned childbearing. Yet, early childbearing in the context of cognitive limitation remains largely unstudied. The present study used a matched-pairs nested case control design to examine cognitive ability as an independent variable; early childbearing and second teen births as outcome variables; and age of initiation, level of reproductive knowledge, level of educational expectations, level of self esteem, and family poverty status as intervening variables that might mediate the effects of the independent and dependent variable relationship. Study subjects were women in the National Longitudinal Survey of Youth (NLSY) (N = 2,094) who were between the ages of 14 and 22 at the beginning of the NLSY study. One third of the study sample (n = 706) were women who gave birth to a child before their 18 th birthday. They were matched at a ratio of 1 to 2 with women who did not give birth before age 18 on variables of age, race, geographic region, and urban-rural status. Results show that poverty ( OR 1.8, CI 1.4, 2.4, p < .001) and low cognitive ability ( OR 2.0, CI 1.7, 3.7, p < .001) significantly increase the odds that a woman will give birth before age 18. Furthermore, low cognitive ability, independent of poverty, significantly increases the odds of a second birth before age 20 ( OR 2.9, CI 1.7, 4.9, p < .001). In sum, this study provides a quantitative basis for considering low intellectual function as an important risk factor for adolescent pregnancy.

ProQuest Publication Number

Document on ProQuest

ProQuest ID

9952583

ISBN

978-0-599-54958-6

Comments

DrPH

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