Hospitalisation for non-lethal self-harm and premature mortality in the 3 years following adolescent pregnancy: Population-based nationwide cohort study

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Goueslard, Karine | Jollant, Fabrice | Cottenet, Jonathan | Bechraoui-Quantin, Sonia | Rozenberg, Patrick | Simon, E. G. | Quantin, Catherine

Edité par CCSD ; Wiley -

International audience. Objective: To evaluate the risk of non-lethal self-harm and mortality related to adolescent pregnancy. Design: Nationwide population-based retrospective cohort. Setting: Data were extracted from the French national health data system. Population: We included all adolescents aged 12–18 years with an International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) code for pregnancy in 2013–2014. Methods: Pregnant adolescents were compared with age-matched non-pregnant adolescents and with first-time pregnant women aged 19–25 years. Main outcome measures: Any hospitalisation for non-lethal self-harm and mortality during a 3-year follow-up period. Adjustment variables were age, a history of hospitalisation for physical diseases, psychiatric disorders, self-harm and reimbursed psychotropic drugs. Cox proportional hazards regression models were used. Results: In 2013–2014, 35 449 adolescent pregnancies were recorded in France. After adjustment, pregnant adolescents had an increased risk of subsequent hospitalisation for non-lethal self-harm in comparison with both non-pregnant adolescents (n = 70 898) (1.3% vs 0.2%, HR 3.06, 95% CI 2.57–3.66) and pregnant young women (n = 233 406) (0.5%, HR 2.41, 95% CI 2.14–2.71). Rates of hospitalisation for non-lethal self-harm were lower during pregnancy and higher between 12 and 8 months pre-delivery, 3–7 months postpartum and in the month following abortion. Mortality was significantly higher in pregnant adolescents (0.7‰) versus pregnant young women (0.4‰, HR 1.74, 95% CI 1.12–2.72), but not versus non-pregnant adolescents (0.4‰, HR 1.61, 95% CI 0.92–2.83). Conclusions: Adolescent pregnancy is associated with an increased risk of hospitalisation for non-lethal self-harm and premature death. Careful psychological evaluation and support should be systematically implemented for adolescents who are pregnant.

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