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To determine if an association exists between hypertension in adulthood and a history of adolescent birth.
We conducted a cross-sectional study using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) cycles 2005-2016. Analysis was limited to women age 20 or older who had experienced at least one live birth and were not currently pregnant (n=9,584). Hypertensive status was defined either by self-report of prior diagnosis or by mean systolic blood pressure (SBP) ≥ 130 mm Hg and/or diastolic blood pressure (DBP) ≥ 80 mm Hg during NHANES examination. Analyses utilized Chi-square and two-sample t tests with p ≤ 0.05. Regression models with adjustment for covariates were utilized to estimate the association between adolescent birth and hypertension.
In our sample, there were more women with hypertension among those with a history of adolescent birth compared to those without (57.7% vs. 53.1%, respectively). Adjusted for age and race/ethnicity, the odds of hypertension in adulthood among women with a history of adolescent birth was 1.48 times the odds among women without a history of adolescent birth (95% CI: 1.28, 1.70). The ratio of family income to poverty threshold, parity, and pack-years of smoking did not significantly affect the model. Education and body mass index (BMI) were included in the adjusted model to test for mediation, and resulted in a partially attenuated magnitude of the association (OR 1.26; 95% CI: 1.09, 1.44). Upon stratification by BMI, the association between adolescent birth and hypertension was particularly strong in normal weight and obese women (Table 1).
In a nationally representative sample of women over age twenty with a history of live birth, we found a significant association between history of adolescent birth and hypertension in adulthood. The results suggest that despite differences in socioeconomic status and health indicators, women with a history of adolescent birth have increased risk of hypertension in adulthood as compared to women whose first birth occurred after adolescence. These findings should motivate increased support for primary prevention efforts for adolescent pregnancy, and alert providers to the need for early lifestyle interventions and increased screening in this population.