Associations between multiple pregnancies and health risk behaviors among U.S. adolescents

Purpose: This study examined the associations between health risk behaviors (i.e., substance use behaviors, physical violence, or carried a weapon) and multiple adolescent pregnancies (i.e., experiencing or causing more than one pregnancy). Methods: We analyzed 1999-2003 data (3 years: 1999, 2001, and 2003) from the National Youth Risk Behavior Survey, a nationally representative survey of high school students (N = 14,211 participants). Multinomial logistic regression was used to compare one and multiple pregnancies versus no pregnancies. Logistic regression was used to compare multiple pregnancies versus one pregnancy. Results: A dose-response relationship was observed between multiple adolescent pregnancies and health risk behaviors; the more risk behaviors endorsed, the greater likelihood of experiencing or causing multiple adolescent pregnancies. Participants who engaged in a "high" degree of risk behaviors were significantly more likely to have experienced or caused multiple adolescent pregnancies than no pregnancies (or only one pregnancy) versus youth who endorsed no risk behaviors. Earlier sexual debut and more lifetime sexual partners were also associated with increased risk of endorsing multiple adolescent pregnancies. Conclusions: The health risk behaviors examined in our study can provide warning signs to influential persons who can potentially deliver important prevention messages to at-risk adolescents.