Publication year
2013
Citation Title
Dependent adolescent pregnancy rates and risk factors for pregnancy in the military health care system.
Journal Name
Military Medicine
Journal Volume
178
Issue Number
4
Page Numbers
412-415
DOI
10.7205/milmed-d-12-00461
Summary
Adolescent pregnancy is related to negative outcomes for adolescents (e.g., school drop-out, poverty) and is financially costly for society. This study examined the incidence of and risk factors for pregnancy among female military dependents in San Antonio, Texas. Findings suggested that incidence rates among military-insured female dependents are lower than overall United States incidence rates, and age and previous contraceptive prescription were associated with increased risk for adolescent pregnancy.
Key Findings
The incidence of adolescent pregnancy among military-insured dependents was 9.67 pregnancies per 1,000 adolescents each year, lower than overall United States incidence rates.
Dependents prescribed contraceptives and those ages 15-19 years, compared to those ages 12-14 or 20-23 years, were at greater risk for unmarried adolescent pregnancy.
Of the 444 pregnancies in the exploratory analyses, 59% of the military dependents were eligible but not enrolled in military insurance or enrolled only briefly at the time of pregnancy diagnosis.
Implications for Program Leaders
Educate military dependents on reproductive health and prevention of adolescent pregnancy
Disseminate information encouraging military parents to enroll their dependents in insurance benefits
Provide information about support programs and medical services available for pregnant adolescent military dependents
Implications for Policy Makers
Continue to support programs that prevent adolescent pregnancy among military dependents by providing education and information about resources
Recommend integrating parent education regarding insurance, especially insurance for dependents, into existing programs for military parents
Encourage the training of professionals who work with adolescent military dependents to discuss sensitive topics regarding pregnancy prevention and resources for adolescent pregnancy
Methods
Retrospective data of all female military-insured dependents, ages 12-23 years, in San Antonio, Texas from 2006 to 2010 were included.
Data regarding age, insurance status at time of pregnancy diagnosis, and prescription of contraceptives were collected via insurance, laboratory, and pharmacy records.
Incidence rates and related risk factors for military adolescent pregnancies were examined.
Participants
The sample included 12,417 unmarried female military dependents with an average age of 15.9 years (SD = 2.9) who were enrolled in military insurance.
No data regarding participants’ race/ethnicity were provided.
Separate exploratory analyses of female military dependents not enrolled in military insurance or enrolled less than nine months were also conducted.
A minority of participants were prescribed contraceptives, including oral contraceptive pills (17%), vaginal rings (1%), and implants or previous emergency contraceptives (> 1 %).
Limitations
Only dependents enrolled in military insurance were included, so results may not generalize to military dependents who receive non-military insurance benefits.
Exploratory analyses of military dependents who were not insured or insured less than nine months were unclearly reported, including no report of sample size.
Texas has one of the highest adolescent pregnancy rates in the United States, and results from this sample may not generalize to adolescents in other geographical locations.
Avenues for Future Research
Examine the effects of reproductive health education on military dependents’ pregnancy rates using a randomized controlled research design
Investigate factors (e.g., cost, coverage) affecting insurance enrollment of military dependents
Compare differences between military and civilian adolescents in rates of pregnancy and risks for adolescent pregnancy
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
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.
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