Young Adult Outcomes Associated With Teen Pregnancy Among High-Risk Girls in a Randomized Controlled Trial of Multidimensional Treatment Foster Care

Abstract

Teen pregnancy is associated with a host of deleterious outcomes for girls, such as drug use and poor parenting. Thus, reducing teen pregnancy rates could improve long-term developmental outcomes for girls, including adjustment during young adulthood. Based on the positive effects of Multidimensional Treatment Foster Care (MTFC) relative to group care (GC) in a study of adolescent girls (significantly fewer pregnancies reported in the 2-year follow-up for MTFC girls), the present study followed this sample into young adulthood (approximately 7 years post-baseline) to examine the effects of adolescent pregnancy on young adult substance use and pregnancy-related outcomes. All participants were randomly assigned to MTFC (N = 81) or GC (N = 85) as adolescents as part of a randomized controlled trial (RCT). Results from logistic regression analyses indicated that becoming pregnant during the 2-year follow-up was significantly related to illicit drug use, miscarriage from a new pregnancy, and child welfare involvement 7 years post-baseline. In addition, baseline marijuana use predicted marijuana use at 7 years post-baseline.

KEYWORDS:

• drug use
• juvenile justice
• RCT
• teen pregnancy
• young adulthood

Acknowledgments

Support for this research was provided by the Oregon Youth Authority and by the following grants: DA015208, DA024672, and DA023920, NIDA, U.S. PHS, and MH054257, NIMH, U.S. PHS. The authors thank Patricia Chamberlain, developer of MTFC and PI of the original studies, for her invaluable contributions to this work. In addition, we thank J. P. Davis and Dana Smith for implementing the intervention; Brandon Gibson, Matthew Rabel, Courtenay Padgett, and Priscilla Havlis for technical assistance; the Oregon Youth Authority directors (Rick Hill and Robert Jester) and the Lane County Department of Youth Services for their assistance and support; and the youths, parents, and foster parents who volunteered to participate in this study.

Notes

Notes. GC = group care; MTFC = Multidimensional Treatment Foster Care. Values represent percentages unless otherwise noted.

Notes. B = unstandardized β; SE = standard error; OR = odds ratio; CI = confidence interval. Marijuana use and other illicit drug use were coded as 0 (negative) or 1 (positive). Two-year follow-up pregnancy was coded as 0 (no pregnancies), 1 (a new pregnancy in one of the time periods), or 2 (a new pregnancy in both time periods).

^a Model R² (N = 137) = .072;.

^b Model R² (N = 136) = .068;.

^c Model R² (N = 157) = .200;.

^d Model R² (N = 145) = .078.

*p < .05. **p < .01.

This strategy increased the number of pregnancies in the 2-year follow-up period very slightly from what was previously published in Kerr et al. (2009). We elected to include the newly added cases in the present study to improve the completeness of the data.

Only two girls indicated a stillbirth. One of those girls also indicated a miscarriage and was therefore already included in this indicator. We included the remaining stillbirth in our miscarriage indicator (the results were similar whether or not this case was included).