Double jeopardy: depressive symptoms and rapid subsequent pregnancy in adolescent mothers.

OBJECTIVE To examine whether depressive symptoms are a risk factor for a subsequent pregnancy in adolescent mothers. DESIGN Secondary analysis from a longitudinal risk-reduction intervention. SETTING Five community-based prenatal sites in Baltimore, Maryland. PARTICIPANTS Two hundred sixty-nine consenting teens, predominantly African American and with low income, who received prenatal care at any of the 5 community-based prenatal sites and completed follow-up questionnaires at 1 or 2 years post partum. Intervention Baseline depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale. Outcome Measure Occurrence of and time to subsequent pregnancy by 2 years post partum. RESULTS Among teens completing at least 1 follow-up questionnaire, baseline depressive symptoms were present in 46%. A subsequent pregnancy by 2 years post partum was experienced by 49%, with a mean (SD) time to first subsequent pregnancy of 11.4 (5.8) months. Depressive symptoms were associated with increased risk of subsequent pregnancy in both unadjusted models (hazard ratio, 1.44; 95% confidence interval, 1.01-2.03) and adjusted models (hazard ratio, 1.44; 95% confidence interval, 1.00-2.01). CONCLUSIONS Depressive symptoms may be an independent risk factor for subsequent pregnancy in African American adolescent mothers. Because depression is treatable, future studies should evaluate whether improved recognition and treatment of adolescent depression reduces the risk of rapid subsequent pregnancy.