Health risk behaviors among pregnant adolescents with older partners

Objective: To determine if pregnant adolescents with older (≤5 years) adult (≤20 years) vs same-age (± 2 years) male partners are at increased health risk. Design: Medical charts of pregnant adolescents who participated in a structured interview as part of their prenatal care were reviewed. Setting: Outpatient maternal and child health clinic at a university teaching hospital. Patients: A total of 503 white, African American, and Mexican American adolescents, aged 12 to 17 years, who initiated prenatal care between January 19, 1992, and December 19, 1994, were consecutively sampled. Main Outcome Measure: We hypothesized that female adolescents paired with older-adult vs same-age partners would be more likely to report recent substance use, high-risk sexual behaviors, and partner-directed violence. Results: Of the sample, 26% (n=129) had an older-adult partner, whereas 44% (n=222) had a same-age partner. The remaining adolescents who did not fit either definition (n=152) were excluded from further analysis. Logistic regression analyses demonstrated that girls with older-adult partners were more likely to have initiated sexual intercourse before 13 years (odds ratio [OR] = 2.1), have discontinued school (OR=2.8), have used marijuana in the past 30 days (OR=2.9), be married or living with their partner (OR=3.2), and desire their current pregnancy (OR=2.1). These young women also were more likely to report that their partner was employed (OR = 2.8), had other children (OR=7.4), and used alcohol during the week (OR=2.0). No association between tobacco use or partner-directed violence and partner age was observed. Conclusion: Pregnant adolescents with older-adult male partners report risk behaviors that may affect their health and that of their unborn child but are not more likely to experience partner-directed violence.