Influence of socioeconomic factors on attaining targets for reducing teenage pregnancies.
Authors: T Smith
Journal: BMJ (1993)

To determine the rate of pregnancy and outcome in teenagers in areas of different socioeconomic conditions, and to assess the implication for achievement of government and local targets in reducing unwanted pregnancies in teenagers.Records of pregnancies were obtained from hospital discharge files and rates of live and still births and abortions calculated for each postcode sector. Postcodes were grouped by categories of deprivation and by local government district.Tayside, Scotland.Teenage girls admitted to National Health Service hospitals for delivery or abortion in 1980-90.Conception in girls aged under 16 by area of residence and relative proportion leading to live births or terminations. Rate of different outcomes in girls under the age of 20 by area of residence.The pregnancy rate in girls aged under 16 was three times as high, and in all girls under 20 six times as high in the most deprived areas as in the most affluent areas. The proportion of teenage pregnancies ending in abortions was higher in the affluent areas, where two out of three ended in abortion compared with one out of four in the deprived areas.Although there was a higher pregnancy rate in teenagers in more deprived areas, the proportion ending in abortion was greater in more affluent areas, possibly due to social and parental pressure. The wide geographical variation in patterns of teenage pregnancy indicates the need for a small area rather than a regional approach to setting targets and devising measures of achieving them.The objective was to determine the rate of pregnancy in teenagers in areas of different socioeconomic conditions to reduce unwanted pregnancies. Details of all patients admitted to Tayside, Scotland, hospitals between 1 January 1980 and 31 December 1990 were obtained and rates of live and still births and abortions were calculated for postcode sectors categorized by deprivation. Pregnancy outcomes were also evaluated in teenage girls admitted to National Health Service hospitals for delivery or abortion in 1980-90, as well as live births or terminations in girls aged under 16 by area of residence and outcomes in girls under the age of 20 by area of residence. During the 1980s the rate of conception in girls under 16 was 3 times higher in the most deprived areas than in the most affluent. In the deprived areas, however, 1 in 2 pregnancies ended in abortion compared to 2 in 3 in the most affluent areas. The annual rate in Dundee District was 11.6 conceptions/1000 girls aged 13 to 15 compared to 5.4/1000 in Perth and Kinross and 8.3/1000 in Angus. Between 1980 and 1990, 40% of the girls who conceived before their 16th birthday did not give birth or have their pregnancy terminated until after they were 16. The overall rate of teenage pregnancies increased dramatically from the most affluent to the most deprived areas. In the most deprived sectors, about 1 in 4 pregnancies ended in abortion compared with about 2 in 3 in the most affluent sectors. Between 1980 and 1990 there were 1075 girls who had had 2 pregnancies: 18% (193) were married on both occasions, and 175 had 2 live births. Among single girls at the end of both pregnancies, 32% (225) had live births (or still births) on both occasions compared with 20% (142) terminating their pregnancies on both occasions. Although there was a higher pregnancy rate in more deprived areas, the proportion ending in abortion was greater in more affluent areas, possibly occasioned by social and parental pressure.