Dependent Adolescent Pregnancy Rates and Risk Factors for Pregnancy in the Military Health Care System

Background: We sought to determine the pregnancy rate of U.S. military-dependent adolescents enrolled in the military healthcare system. Methods: We examined the age and insurance status of dependent adolescents, ages 12 to 23, and determined the incidence of new pregnancies in the military healthcare system from 2006 to 2010 in San Antonio, Texas. Adolescents not enrolled or only recently enrolled in TRICARE Prime at the time of pregnancy were analyzed separately. A Cox-Proportional Hazards model was used to determine risk factors for pregnancy (relationship to sponsor, age, and contraceptive prescription). Results: 444 pregnancies were diagnosed among the 12,417 eligible subjects. For adolescents with continuous enrollment in TRICARE Prime, the pregnancy rate was 9.67/1,000 woman-years at risk, much lower than the national average. Cox-Proportional Hazards analysis showed age group (15_19 years), and history of oral contraceptive prescription were associated with a higher pregnancy rate. 59% of pregnancies occurred in women not enrolled or only briefly enrolled in TRICARE Prime at the time of pregnancy. Conclusion: Dependent daughters enrolled in TRICARE Prime had a very low pregnancy rate. The majority of pregnancies occurred in adolescents not enrolled in TRICARE Prime at the time of pregnancy diagnosis, suggesting many adolescents sought health insurance after pregnancy was diagnosed.