In this sample, nearly 40% of the respondents were non-Hispanic black and 60% were less than 18 years of age. Approximately 70% of the fathers and mothers of these adolescents had completed high school. Sixty percent of adolescents did not live in a home with both biologic parents at age 2 (). Teenage parenthood—overall (data not shown) and among males and females—was associated with individual, family, and contextual demographic characteristics (). Additionally, mental health scores at year 0 differed significantly by sex, age, parental relationship quality, and PIAT score (all P < 0.05) (data not shown). On average, among those who eventually became teenage parents, year 0 mental health scores were measured 349 days prior to the birth of their first child.
Individual, Family, and Contextual Characteristics, Overall and by Teenage Parenthood Stratified by Sex, National Longitudinal Survey of Youth, 1997
Teenage parenthood and mental health
The average mental health score ranged from 10.00 (standard deviation (SD) = 2.56) at year 0 to 10.44 (SD = 2.52) at year 6 (). In unadjusted analysis, overall, parenting teenagers had lower mental health scores than nonparenting teenagers at each timepoint (all P < 0.01) (data not shown). However, among females, teenage mothers and nonparenting teenagers had similar mental health scores at year 0 (9.40 vs. 9.67; P = 0.128) but differed at year 2 (9.54 vs. 10.03; P = 0.005), year 4 (9.61 vs. 10.32; P < 0.001), and year 6 (9.86 vs. 10.44; P = 0.007) (). Conversely, among males, teenage fathers had lower mental health scores than nonparenting teenagers at year 0 (10.31 vs. 10.99; P = 0.004) and year 2 (9.89 vs. 10.71; P < 0.001), but they did not differ at year 4 (10.62 vs. 10.88; P = 0.309) or year 6 (10.80 vs. 10.86; P = 0.837) ().
Mean Mental Health Score (SD) at Years 0, 2, 4, and 6, Overall and by Teenage Parenthood Stratified by Sex, National Longitudinal Survey of Youth, 1997
In multivariate analysis, on average, mental health scores improved over time, with a one-tenth point increase in mental health score each year of follow-up (estimate = 0.097, standard error (SE) = 0.013; P < 0.001) (data not shown). Overall, changes in mental health scores over time did not differ for parenting teenagers compared with nonparenting teenagers (for teenage parenthood × year interaction, estimate = −0.007, SE = 0.027; P = 0.806) (). However, after adding interactions for sex, males and females differed in the effect that teenage parenthood had on mental health over time (for teenage parenthood × male × year interaction, estimate = 0.190, SE = 0.055; P < 0.001) (). Additionally, the form of the mental health trajectories differed by sex (for male × year × year interaction, estimate = 0.035, SE = 0.014; P = 0.016) (). Specifically, among males, mental health changes were quadratic in nature (P = 0.007); however, the changes among females were not (P = 0.838) ().
Changes in Mental Health Score at Baseline and at 2-, 4-, and 6-Year Follow-up, National Longitudinal Survey of Youth, 1997a
Changes in Mental Health Score, Stratified by Sex, National Longitudinal Survey of Youth, 1997a
Notably, after adjustment for baseline covariates and the functional form of the trajectories, the modifying effect of sex on the relation between teenage parenthood and mental health trajectories remained (estimate = 0.191, SE = 0.055; P < 0.001) (). At year 0, males who became teenage fathers had significantly worse mental health scores than males who did not become teenage fathers (adjusted difference = −0.76; P = 0.008) (). Over time, the mental health scores of teenage fathers improved, while scores of nonparenting teenage males remained relatively stable (estimate = 0.119, SE = 0.046; P = 0.009) (). As a result, teenage fathers and nonparenting teenage males had similar scores at 6-year follow-up (adjusted difference = −0.06; P = 0.890) (). Conversely, at year 0, females who became teenage mothers had similar mental health scores as females who did not become teenage mothers (adjusted difference = −0.25; P = 0.457) (). However, over time, the mental health scores of teenage mothers improved at a slower rate than those of nonparenting teenage females (estimate = −0.073, SE = 0.032; P = 0.024) (), resulting in larger differences in mental health scores at the 6-year follow-up, with teenage mothers having worse mental health scores (adjusted difference = −0.66; P = 0.016) ().
Figure 1. Adjusted mental health scores at years 0, 2, 4, and 6, stratified by sex and teenage parenthood, National Longitudinal Survey of Youth, 1997. Mental health scores were adjusted for percent of poverty level, paternal education, maternal education, both (more ...)