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The European Journal of Public Health Advance Access originally published online on March 25, 2007
The European Journal of Public Health 2007 17(6):630-636; doi:10.1093/eurpub/ckm014
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© The Author 2007. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Miscellaneous

Factors associated with teenage pregnancy in the European Union countries: a systematic review

Mari Imamura1, Janet Tucker1, Phil Hannaford2, Miguel Oliveira da Silva3, Margaret Astin4, Laura Wyness5, Kitty W. M. Bloemenkamp6, Albrecht Jahn7, Helle Karro8, Jørn Olsen9, Marleen Temmerman10 on behalf of the REPROSTAT 2 group

1 Dugald Baird Centre for Research on Women's Health, Department of Obstetrics and Gynaecology, University of Aberdeen, UK
2 Department of General Practice and Primary Care, University of Aberdeen, Aberdeen, UK
3 Instituto de Medicina Preventiva, Faculdade de Medicina de Lisboa, Lisbon, Portugal
4 IMMPACT, Department of Public Health, University of Aberdeen, Aberdeen, UK
5 Department of Public Health, University of Aberdeen, UK
6 Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands
7 Department of Tropical Hygiene and Public Health, Heidelberg, Germany
8 Tartu University Women's Clinic, Tartu, Estonia
9 Department of Epidemiology, University of California, Los Angeles, USA
10 International Centre for Reproductive Health, Ghent University, Ghent, Belgium

Correspondence: Mari Imamura, Dugald Baird Centre for Research on Women's Health, Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen AB25 2ZL, UK, tel: 01224 553621, fax: 01224 553708, e-mail: m.imamura{at}abdn.ac.uk

Received August 11, 2006 , accepted January 29, 2007

Background: As part of the REPROSTAT2 project, this systematic review aimed to identify factors associated with teenage pregnancy in 25 European Union countries. Methods: The search strategy included electronic bibliographic databases (1995 to May 2005), bibliographies of selected articles and requests to all country representatives of the research team for relevant reports and publications. Primary outcome measure was conception. Inclusion criteria were quantitative studies of individual-level factors associated with teenage (13–19 years) pregnancy in EU countries. Results: Of 4444 studies identified and screened, 20 met the inclusion criteria. Most of the included studies took place in UK and Nordic countries. The well-recognized factors of socioeconomic disadvantage, disrupted family structure and low educational level and aspiration appear consistently associated with teenage pregnancy. However, evidence that access to services in itself is a protective factor remains inconsistent. Although further associations with diverse risk-taking behaviours and lifestyle, sexual health knowledge, attitudes and behaviour are reported, the independent effects of these factors too remain unclear. Conclusions: Included studies varied widely in terms of methods and definitions used. This heterogeneity within the studies leaves two outstanding issues. First, we cannot synthesize or generalize key findings as to how all these factors interact with one another and which factors are the most significant. Second, it is not possible to examine potential variation between countries. Future research ensuring comparability and generalizability of results related to teenage sexual health outcomes will help gain insight into the international variation in observed pregnancy rates and better inform interventions.

Keywords: EU countries, factors, pregnancy, teenage, review


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