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Conception rates reduced in women aged younger than 18 years

Conception rates among women aged younger than 18 years dropped steadily from 1996-1998 onward, and more rapidly after 2007, in England, according to recent study findings.

“In 1999, the U.K. Government launched a 10-year, nationwide Teenage Pregnancy Strategy in England with the dual aims of achieving a 50% reduction in conception rates in women younger than 18 years by 2010, and mitigating social exclusion in teenage parents by increasing their participation in education, employment, or training,” Kaye Wellings, FRCOG, and colleagues wrote. “Conception rates in women younger than 18 years fell by 51% between 1998 and 2014 in England. Of interest is the extent to which the decline seems to be related to the Teenage Pregnancy Strategy and other interventions; whether the decline has been seen equally in the most and least disadvantaged women; and what factors remain associated with conception in women younger than 18 years.”

The researchers conducted an observation study in which they used random-effects meta-regression to examine the change in conception rates from 1994-1998 to 2009-2013 in relation to Teenage Pregnancy Strategy–related expenditure per person, socioeconomic deprivation, and region. Individual-level data from three waves of the National Survey of Sexual Attitudes and Lifestyles (Natsal) — Natsal-1 (1990–1991), Natsal-2 (1999–2001), and Natsal-3 (2010–2012) — were used to assess conception rates in women younger than 18 years and the prevalence of participation in education, work, and training among women conceiving before the age of 18 years.

Wellings and colleagues found conception rates in women younger than 18 years declined steadily after peaking in 1996-1998, and then declined more rapidly after 2007. Women who received more Teenage Pregnancy Strategy-related funding and those in more economically deprived areas had higher rates of conception in 1994-1998 and greater reductions in 2009-2013.

Regression analyses evaluating the association between Teenage Pregnancy Strategy support and cut in conception rates of those younger than 18 years revealed an estimated reduction in the conception rate of 11.4 births (95% CI, 9.6-13.2; P < .0001) per 1000 women aged 15 to17 years for every £100 (~$131.21) Teenage Pregnancy Strategy spend per person with a decrease of 8.2 conceptions (95% CI, 5.8-10.5; P < .0001) after modification for region and socioeconomic deprivation.

When the researchers compared Natsal-2 and Natsal-3, the connection between conception among women aged 18 years or younger and lower socioeconomic status weakened. The number of women with a child conceived before age 18 who participated in education, work, or training was low; however, the chances of them doing so doubled between Natsal-2 and Natsal-3 (OR = 1.99, 95%, CI 0.99-4).

“Progress has been made towards halting the cycle of poverty and income inequality long associated with early pregnancy, and in improving the life chances of young mothers,” Wellings and colleagues wrote. “Taken as a whole, the evidence underlines the importance of long-term, sustained, multifaceted prevention strategies to tackle the more intractable public health challenges.” – by Savannah Demko

Disclosure: The researchers report no relevant financial disclosures.