Study Highlights Need for Integrated, Trauma-Informed Care for Pregnant and Parenting Adolescents

A recent study from The Hospital for Sick Children (SickKids) reveals alarming risks for pregnant adolescents in Ontario, Canada. The findings, published in JAMA Network Open, showed a correlation between teen pregnancy and increased likelihood of residing in lower-income neighborhoods with lower rates of high school completion.

“It’s essential that we recognize how the social determinants of health are embedded within people’s lives and implement trauma-informed programs that meet people where they are at,” said Ashley Vandermorris, MD, Staff Physician in the Division of Adolescent Medicine at SickKids, and co-author of the study. “Our goal is to ultimately improve outcomes for adolescents, from pregnancy to parenthood, and for their child.”

The study, led by Joel Ray, MD, a clinician-scientist at St. Michael's Hospital in Toronto, Canada, used administrative data to track all instances of teen pregnancies and associated fatalities among a cohort of 2.2 million individuals assigned female at birth, spanning from 1991 to 2021.

The analysis showed that, compared to non-pregnant peers, pregnant teens faced a 50 percent higher risk of premature death before age 31, with higher risks for those with multiple pregnancies or pregnancies before age 16. According to the researchers, socioeconomic factors also played a role, with pregnant teens more likely to live in lower-income neighborhoods with lower high school completion rates.

“The longer-term risk of premature death, whether injury or noninjury-related, is significantly increased for pregnant teenagers,” said Eyal Cohen, MD, Program Head of the Child Health Evaluative Sciences program at SickKids. “We need programs that address the interconnectedness of health care and social determinants of health.”

For example, the authors explained that at SickKids, there are two programs, the Young Prenatal Program (YPP) and the Young Families Program (YFP), dedicated to closing the care disparities faced by adolescent parents. These programs offer comprehensive physical, mental, and developmental care, supporting them from pregnancy through their early parenting journey.

"Adolescents entering the program come from a variety of backgrounds. What we provide is more than medical care; it is an integrated model that takes into consideration the situation of each person we support," said Jasmine Saleh, a social worker at SickKids. "We hope to help expand the conversation about what it means to be a parent and be a resilient, loving caregiver."

According to the authors, this study’s results underscore the urgency of prioritizing the health and well-being of pregnant adolescents and young families. They concluded that collaborative efforts and comprehensive support systems could pave the way for a brighter, healthier future for adolescent parents and their children.