Abstract
Introduction: Teen pregnancy (TP), defined as pregnancy between 10 and 19 years, is associated with adverse pregnancy outcomes and perpetuates socioeconomic disadvantage, but the impact in later life is not well studied. We investigated the association of TP with premature major adverse cardiovascular events (PMACE) Methods: We used data from the National Health and Nutrition Examination Survey 1999–2018. Surveys were linked with the National Death Index to ascertain mortality records. Only adult females aged 20 years and older were included in the analysis. Participants were divided into 3 groups based on age at their first life birth: 19 or younger (TP), 20 and above (non-TP), and nulliparous women (NP). TP was ascertained by age at first life birth ≤ 19 years, and PMACE was defined as any self-reported diagnosis of coronary artery disease, stroke, heart failure, or all-cause mortality occurring before age 65. We assessed the association between these groups and PMACE using univariate and multivariate logistic regression models. Result: Among 19,737 (weighted frequency of 83,450,668) adult females, 24.2% had a history of TP, 54.3% had a history of non-TP and 21.5% were NP. Compared with NP females, females with TP had a higher odd of PMACE with an unadjusted odd ratio of 3.75 (95%CI, 2.80 - 5.01) versus 2.07 (1.55 – 2.75) among non-TP. Adjusting for age, race, alcohol use, smoking, and social determinants of health factors such as income, educational status, insurance status, and food insecurity, TP remained independently associated with higher odds of PMACE with an adjusted odd ratio of 1.66 (95%CI, 1.19 – 2.30); p=0.003, but this association was not statistically significant among non-TP females with aOR 1.32 (0.95 – 1.84); p=0.10. Conclusion: Teen pregnancy was associated with higher likelihood of PMACE. This association may be indicative of the enduring impact of social determinants of health factors associated with teen pregnancy into adulthood.
Published Version
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