AHRQ Stats: Teen Childbirth

AThe rate of teen hospital stays for childbirth fell 40 percent nationwide between 2004 and 2013. Reductions ranged from 25 percent to 50 percent among 36 states. The smallest decreases were in Kentucky (down 19 percent), Nebraska (12 percent) and West Virginia (5 percent). (Source: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project Statistical Brief #208: Teen Hospital Stays for Childbirth, 2004-2013.)

Teen Hospital Stays for Childbirth, 2004-2013

Kathryn R. Fingar, Ph.D., M.P.H., and Megan M. Hambrick, M.S.W.

Introduction

The national teen birth rate has declined almost continuously over the last several decades, from a high of 61.8 per 1,000 females aged 15-19 years in 1991 to 24.2 in 2014.¹ Nevertheless, the rate remains higher in the United States than in many other industrialized countries.² The teen birth rate also remains higher in certain regions of the United States, such as the South.³

Not only can teen pregnancy have immediate and long-term social and economic consequences, such as lower educational attainment, unemployment, and poverty,⁴ teen mothers and their infants often have poor health outcomes. Compared with older women who give birth, pregnant teens have been found to be more likely to start prenatal care later, to smoke or abuse other substances during pregnancy, and to suffer from mental illness.^5,6 Teens also have higher rates of certain pregnancy-related complications than older women, including pregnancy-induced hypertension and anemia, and they are more likely to deliver a preterm or low-birth-weight infant.⁷

This Healthcare Cost and Utilization Project (HCUP) Statistical Brief updates a previously published Brief⁸ and presents data on hospital stays for childbirth among teens aged 15-19 years from 2004 through 2013. Characteristics and complications of pregnancy among teen stays for childbirth are compared with childbirth stays among women aged 20-44 years in 2013. Trends in the rate of teen hospital stays for childbirth from 2004 through 2013 are presented for patient subgroups, regions of the United States, and individual States. All data are reported for the hospital stay of the mother rather than the newborn. Differences of greater than 10 percent are noted in the text.

Findings

Characteristics of teen hospital stays for childbirth, 2013
Table 1 presents the frequency, population-based rate, mean length of stay, and mean and aggregate costs of hospital stays for childbirth among females aged 15-19 years in 2013, overall and by subgroup.

Highlights

In 2013, childbirth was the leading reason for teen hospital stays, constituting nearly half of all inpatient hospitalizations among females aged 15-19 years.

Of the 265,370 teen hospital stays for childbirth in 2013, which amounted to $1.1 billion in hospital costs, over 70 percent were paid by Medicaid.

The rate of teen hospitalizations for childbirth increased from 2004 through 2007 from 41.8 to 44.5 stays per 1,000 females aged 15-19 years but thereafter decreased to 24.9 in 2013.

From 2007 through 2013, the rate of childbirth hospitalizations decreased faster for teens aged 15-17 years than for those aged 18-19 years (50 vs. 42 percent decrease).

Across States, the rate of teen hospitalizations for childbirth varied by a factor of 3.

The rate of teen hospitalizations for childbirth was highest in the South at 80.5 in 2004. Through 2013, the rate decreased by 35 percent in the South compared with a decrease of over 40 percent in other regions. Thus, the rate in the South (52.3) remained higher than in any other region in 2013.

Teen hospital stays for childbirth also were highest and declined the least in low-income, micropolitan, and rural areas.

Although teens were less likely to have a C-section than women aged 20-44 years, they were more likely to have pre-eclampsia or eclampsia, poor fetal growth, and anemia.