Determinants of underage induced abortion - the 1987 Finnish Birth Cohort study

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 95; no. 5; pp. 572 - 579
• Main Authors: Leppälahti, Suvi, Heikinheimo, Oskari, Paananen, Reija, Santalahti, Päivi, Merikukka, Marko, Gissler, Mika
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.05.2016; John Wiley & Sons, Inc
• Subjects: Abortion; Abortion, Induced - statistics & numerical data; Adolescent; Behavior disorders; Birth weight; Child & adolescent psychiatry; Childbirth & labor; Cohort analysis; Cohort Studies; Drug abuse; Emotional disorders; Epidemiology; Female; Finland - epidemiology; Foster care; Foster Home Care - psychology; Foster Home Care - statistics & numerical data; Health risk assessment; Humans; induced; Mental Disorders - complications; Mental Disorders - epidemiology; Mental Disorders - physiopathology; Parturition; Pregnancy; pregnancy in adolescence; Pregnancy in Adolescence - prevention & control; Pregnancy Outcome - epidemiology; Quantitative analysis; Reproductive health; Risk Factors; Smoking - adverse effects; Smoking - epidemiology; Socioeconomic Factors; Teenage pregnancy; Teenagers; Finland; epidemiology; pregnancy in adolescence; Abortion; reproductive health; induced
• ISSN: 0001-6349; 1600-0412
• DOI: 10.1111/aogs.12879

Introduction Although underage pregnancies often end in induced abortion, data on girls who undergo termination of pregnancy are lacking. Our aim was to identify determinants of underage induced abortion and compare them with those of childbirth. Material and methods All girls born in 1987 in Finland surviving the perinatal period (n = 29 041) were included in the study and divided into three study groups: Girls undergoing induced abortion (n = 1041, 3.6%) or childbirth (n = 395, 1.4%) at <18 years of age and girls with no underage pregnancies (n = 27 605, 95.0%). Results Shared risk factors of underage induced abortion and childbirth included early onset behavioral and emotional disorders [adjusted OR 1.9 (1.4–2.5) and 2.7 (95% CI 1.8–3.9)], a history of foster care [1.5 [1.1–1.9] and 3.0 [2.3–4.1)], and socioeconomic factors, including living in a family receiving income support [1.8 (1.5–2.1) and 3.4 (2.7–4.4)], respectively. Specific risk factors of underage induced abortion were psychoactive substance use disorders [2.2 (1.3–3.5)], having a mother who smoked during pregnancy [1.5 (1.3–1.8)] or had undergone induced abortion [1.8 (1.5–2.2)]. Coping with a chronic physical illness [0.7 (0.5–0.9)], and perinatal problems [0.6 (0.4–0.7)] were inversely associated with underage induced abortion. Conclusions The traditionally acknowledged determinants of underage childbirth played a less prominent role in induced abortion. Novel risk factors of underage induced abortion were found, including severe substance abuse and adverse maternal reproductive history, and should be addressed at all levels offering youth healthcare and social welfare services.