Increased risk of premature death following teenage abortion and childbirth-a longitudinal cohort study.

Background: Teenage pregnancy is associated with an increased risk of premature death. However, it is not known whether the outcome of pregnancy, i.e. induced abortion or childbirth, affects this risk.

Methods: A Finnish population-based register study involving a cohort of 13 691 nulliparous teenagers who conceived in 1987-89; 6652 of them underwent induced abortion and 7039 delivered. The control group consisted of 41 012 coeval women without teenage pregnancy. Follow-up started at the end of pregnancy and lasted until 6th June 2013.

Results: Women with teenage pregnancy had a higher risk of overall mortality vs. controls (mortality rate ratio [MRR] 1.6, [95% CI 1.4-1.8]) and were more likely to die prematurely as a result of suicide, alcohol-related causes, circulatory diseases and motor vehicle accidents. A low educational level appeared to explain these excess risks, except for suicide (adj. MRR 1.5, [95% CI 1.1-2.0]). After adjusting for confounders, the childbirth group faced lower risks of suicide (adj. MRR 0.5, [95% CI 0.3-0.9]) and dying from injury and poisoning (adj. MRR 0.6, [95% CI 0.4-0.8]) compared with women who had undergone abortion.

Conclusions: A low educational level is associated with the increased risk of premature death among women with a history of teenage pregnancy, except for suicide. Extra efforts should be made to encourage pregnant teenagers to continue education, and to provide psychosocial support to teenagers who undergo induced abortion.