Risk of Unintended Pregnancy among Adolescent and Young Adult Women: The Roles of Social Discrimination and Mental Health

Kelli S. Hall, University of Michigan
Heather Gatny, University of Michigan

We investigated relationships between social discrimination, mental health and unintended pregnancy. Data were drawn from 794 women 18-20 years in a longitudinal cohort study. Baseline and weekly surveys assessed information on social context including discrimination (EDS), stress (PSS), depression (CES-D), and reproductive outcomes. Multi-level, mixed-effects regression and discrete-time hazard models estimated associations between discrimination, mental health and pregnancy. Baron and Kenny’s method was used to test mediation effects of mental health on discrimination and pregnancy. The mean discrimination score was 19/45 points; 20% reported moderate/high discrimination. Discrimination scores were higher among women with stress and depression versus those without (21 versus 18 points for both, p’s<0.001). Pregnancy rates (14% overall) were higher among women with moderate/high (23%) versus low (11%) discrimination (p<0.001). Discrimination predicted stress (aOR 2.2, 95%CI 1.4,3.4), depression (aOR 2.4, CI 1.5,3.7), and pregnancy (aOR 1.8, CI 1.1,3.0). Stress and depression did not mediate discrimination’s effect on pregnancy.