This proposal offers to utilize the individual person-based, computerized, population information and health related national registers in Denmark for testing hypotheses on the effects of adolescent pregnancy loss as compared to same age childbearing or pregnancy experience. We hypothesize that there will be no significant differences in effects on subsequent reproductive health (as measured by gestation of less than 37 weeks, birth weight less than 2,500 grams, spontaneous second trimester abortion, still birth, or other pregnancy, labor, or delivery complications) following a first pregnancy that was either carried to term or terminated. We further hypothesize that women will be at greater risk for reproductive health effects following one or more repeat abortions before attempting a first delivery. Additional hypotheses postulate that the experience of severe psychological stress (as measured by admission to psychiatric hospital) will be about the same 3 months postabortion or postpartum but that both postabortion and postpartum adolescent women are at higher risk for first ever admission to psychiatric hospital than never pregnant same age adolescents. Further, termination of unwanted pregnancies will have fewer negative effects when compared to same age childbearing in terms of educational attainment (school grade reached) and economic achievement (employment, income, and occupational status) over time. We propose to obtain the needed data by tracking longitudinally through the Central Person Register, birth, abortion, and psychiatric admissions registers, and other needed national registers, each of the 38,364 women born in 1963 who became 15 years old in 1978 for 5 years as they pass through ages 15, 16, 17, 18, and 19. The independent variables are the reproductive event groups. Control variables are marital status, parity, period of adolescence, maternal adolescent pregnancy experience, family socioeconomic status, and citizenship. Dependent variables are the effects cited in the hypotheses. Following creation of the study cohort and identification of reproductive events and patterns, profiles will be developed and consequences identified by means of cluster analyses, discriminant function analysis, survival analysis, and logistic regression analysis. We also hope to test the maxim that 15 to 20 percent of all confirmed pregnancies end in spontaneous abortion and to establish a public data archive. Results are expected to be of value to adolescents, parents, service providers, and policy makers in Denmark and in the United States.
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