Teen mums at high risk of adverse psychiatric outcomes

Pregnant and postpartum adolescents represent a distinct group with markedly elevated risk of psychiatric morbidity and associated adverse outcomes, as shown in a retrospective study.

Researchers used health administrative data from Ontario, Canada, and identified all 992,729 singleton livebirth or stillbirths after 20 weeks of gestation between 2013 and 2021. Births were categorized according to the pregnant individual’s age at conception: adolescent (aged <20 years) or adult (aged ≥20 years).

Outcomes of interest included any psychiatric diagnosis between conception and 1 year postpartum, as well as adverse psychiatric outcomes (emergency department visit, inpatient admission, and self-injury).

Of the births, 27,547 were among adolescents and 965,182 were among adults. Mean age at conception was 17.9 years for adolescents and 30.5 years for adults.

More adolescents than adults had a prepregnancy history of a psychiatric diagnosis than adults (45.8 percent vs 25.1 percent). Similarly, a psychiatric disorder diagnosis in pregnancy or the first year postpartum was more common among adolescents vs adults (39.8 percent vs 25 percent; adjusted relative risk [aRR], 1.35, 95 percent confidence interval [CI], 1.33–1.37).

Compared with adults, adolescents were also more likely to have visited the emergency department for a psychiatric reason during pregnancy or postpartum (9 percent vs 1.6 percent; aRR, 3.63, 95 percent CI, 3.46–3.81), had a psychiatric admission (2.2 percent vs 0.4 percent; aRR, 3.67, 95 percent CI, 3.33–4.05), or had an episode of self-injury (1.2 percent vs 0.1 percent; aRR, 7.11, 95 percent CI, 6.12–8.26).  

The findings underscore a need for targeted treatments to prevent and treat mental illness in order to improve outcomes in this population.