108 Factors Associated with a History of Pregnancy among Adolescent Street Youth

To determine social and behavioural factors associated with a history of pregnancy among adolescent street youth.

From January 1995 to September 2000, a prospective cohort study of street youth was carried out in Montreal; 1013 participants aged 14 to 25 were recruited. Female participants aged 14 to 19 years were selected and adolescent ever pregnant (AEP) were compared with adolescents never pregnant (ANP) using data from baseline questionnaires.

Among the 1013 participants, 225 (22.2%) met the selection criteria and 94 of them (41.8%) had a history of pregnancy. AEP and ANP had similar demographic and socio-demographic characteristics: their mean age at entry was 17.8 years, 96.9% were Canadian born, 93.3% were French speaking, 58.6% were raised in families with comfortable socioeconomic status, and 54.2% were at least one year behind in school considering their age. However, AEP were more likely than ANP to have been kicked out of home (62.8% vs. 47.3%, p=0.022) and to have run away (78.7% vs. 64.9%, p=0.025). In addition, AEP had their first episode of homelessness at a younger mean age than ANP (13.9 years vs. 14.7 years, p=0.011). Both groups had problematic alcohol and drug use: 31.3% had a CAGE score >2 and 72.2% had a DAST score >6. Almost half (44.0%) had ever injected drugs and among these adolescent injectors, 45.1% had injected more than 100 times. AEP were almost one year younger at initiation into drug injection (15.2 years vs. 16.0 years, p=0.049) and more AEP had started injecting before 14 years of age (25.6% vs. 5.8%, p=0.007). Sexual abuse, either intra-familial or extra-familial, was highly prevalent among these adolescents, however, it was significantly more prevalent among AEP (71.3% vs. 56.5%, p=0.024) and they had had multiple abusers (71.6% vs. 50.0%, p=0.009). AEP were more likely to report intra-familial sexual abuse (39.4% vs. 24.4%, p=0.017) than ANP; as well abuse occurred at an earlier age for AEP than for ANP (mean age: 7.4 vs. 8.9 years, p=0.090) and was more severe: vaginal penetration (62.2% vs. 26.7%, p=0.004) and anal penetration (29.7% vs. 3.3%, p=0.005).

Pregnancy is very common among adolescent street youth. Histories of early and severe intra familial sexual abuse and early injection drug use are strongly associated with a history of pregnancy among these adolescents. Interventions addressing these factors need to be considered when planning global health care and sexual health education for this population.