Clusters of Markers Identify High and Low Prevalence of Adolescent Pregnancy in the US

Abstract

Study ObjectiveTo identify markers that, when clustered, are associated with the highest and lowest pregnancy prevalence among US adolescent females. DesignSecondary database analysis of the National Survey of Family Growth. ParticipantsAdolescent females 15–19 years old. SettingUnited States. MethodsBivariate analyses were performed of the 2002 and 2006-08 cycles to identify markers associated with pregnancy in females 15–19 years old. Recursive partitioning analysis (RPA) was done to identify markers which, when combined, identify adolescent females with the highest and lowest pregnancy prevalence. ResultsPregnancy prevalence in 2,528 adolescent females was 14%. In RPA, females who ever HIV tested had a 48% pregnancy prevalence vs 4% in those never tested. The highest pregnancy prevalence (78%) was associated with the combination of ever HIV tested, never lived away from parents before 18 years old, age >17 years old, and age of sexual debut ≤14 years old. Adolescent females with a combination of ever HIV tested, never lived away from parents before 18 years old, age >17 years old, age of sexual debut at 15–16 years old, and the adolescent's father not having a high-school diploma had a pregnancy prevalence of 75%. ConclusionsTwo clusters of markers yield adolescent females with a very high adolescent pregnancy prevalence, at 75%–78%. Pregnancy prevention efforts might be especially effective when targeting combinations of HIV-testing history, never living away from home before 18 years old, adolescent age, age of sexual debut, and paternal educational attainment.