Social and Biological Transgenerational Underpinnings of Adolescent Pregnancy

Amanda Rowlands, Emma C. Juergensen, Ana Paula Prescivalli, Katrina G. Salvante and Pablo A. Nepomnaschy
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Amanda Rowlands: Maternal and Child Health Laboratory and Crawford Laboratory of Evolutionary Studies, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
Emma C. Juergensen: Maternal and Child Health Laboratory and Crawford Laboratory of Evolutionary Studies, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
Ana Paula Prescivalli: Maternal and Child Health Laboratory and Crawford Laboratory of Evolutionary Studies, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
Katrina G. Salvante: Maternal and Child Health Laboratory and Crawford Laboratory of Evolutionary Studies, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
Pablo A. Nepomnaschy: Maternal and Child Health Laboratory and Crawford Laboratory of Evolutionary Studies, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada

IJERPH, 2021, vol. 18, issue 22, 1-19

Abstract: Adolescent pregnancy (occurring < age 20) is considered a public health problem that creates and perpetuates inequities, affecting not only women, but societies as a whole globally. The efficacy of current approaches to reduce its prevalence is limited. Most existing interventions focus on outcomes without identifying or addressing upstream social and biological causes. Current rhetoric revolves around the need to change girls’ individual behaviours during adolescence and puberty. Yet, emerging evidence suggests risk for adolescent pregnancy may be influenced by exposures taking place much earlier during development, starting as early as gametogenesis. Furthermore, pregnancy risks are determined by complex interactions between socio-structural and ecological factors including housing and food security, family structure, and gender-based power dynamics. To explore these interactions, we merge three complimentary theoretical frameworks: “Eco-Social”, “Life History” and “Developmental Origins of Health and Disease”. We use our new lens to discuss social and biological determinants of two key developmental milestones associated with age at first birth: age at girls’ first menstrual bleed (menarche) and age at first sexual intercourse (coitarche). Our review of the literature suggests that promoting stable and safe environments starting at conception (including improving economic and social equity, in addition to gender-based power dynamics) is paramount to effectively curbing adolescent pregnancy rates. Adolescent pregnancy exacerbates and perpetuates social inequities within and across generations. As such, reducing it should be considered a key priority for public health and social change agenda.

Keywords: adolescent pregnancy; Eco-social Theory (EST); Life History Theory (LHT); Developmental Origins of Health and Disease (DOHaD); inequities; interventions; menarche; coitarche; age at first birth; transgenerational effects (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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