{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:39:39Z","timestamp":1788435579388,"version":"build-2803163510"},"reference-count":53,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the risk of non\u2010lethal self\u2010harm and mortality related to adolescent pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Nationwide population\u2010based retrospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Data were extracted from the French national health data system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>We included all adolescents aged 12\u201318\u2009years with an International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD\u201010) code for pregnancy in 2013\u20132014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pregnant adolescents were compared with age\u2010matched non\u2010pregnant adolescents and with first\u2010time pregnant women aged 19\u201325\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Any hospitalisation for non\u2010lethal self\u2010harm and mortality during a 3\u2010year follow\u2010up period. Adjustment variables were age, a history of hospitalisation for physical diseases, psychiatric disorders, self\u2010harm and reimbursed psychotropic drugs. Cox proportional hazards regression models were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 2013\u20132014, 35\u2009449 adolescent pregnancies were recorded in France. After adjustment, pregnant adolescents had an increased risk of subsequent hospitalisation for non\u2010lethal self\u2010harm in comparison with both non\u2010pregnant adolescents (<jats:italic>n<\/jats:italic>\u00a0=\u00a070\u2009898) (1.3% vs 0.2%, HR\u00a03.06, 95%\u00a0CI 2.57\u20133.66) and pregnant young women (<jats:italic>n<\/jats:italic>\u00a0=\u00a0233\u2009406) (0.5%, HR\u00a02.41, 95%\u00a0CI 2.14\u20132.71). Rates of hospitalisation for non\u2010lethal self\u2010harm were lower during pregnancy and higher between 12 and 8\u00a0months pre\u2010delivery, 3\u20137\u00a0months postpartum and in the month following abortion. Mortality was significantly higher in pregnant adolescents (0.7\u2030) versus pregnant young women (0.4\u2030, HR\u00a01.74, 95%\u00a0CI 1.12\u20132.72), but not versus non\u2010pregnant adolescents (0.4\u2030, HR\u00a01.61, 95%\u00a0CI 0.92\u20132.83).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adolescent pregnancy is associated with an increased risk of hospitalisation for non\u2010lethal self\u2010harm and premature death. Careful psychological evaluation and support should be systematically implemented for adolescents who are pregnant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17432","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T14:54:46Z","timestamp":1676904886000},"page":"1016-1027","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Hospitalisation for non\u2010lethal self\u2010harm and premature mortality in the 3\u2009years following adolescent pregnancy: Population\u2010based nationwide cohort study"],"prefix":"10.1111","volume":"130","author":[{"given":"Karine","family":"Goueslard","sequence":"first","affiliation":[{"name":"Biostatistics and Bioinformatics (DIM), University Hospital Bourgogne Franche\u2010Comt\u00e9 University  Dijon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrice","family":"Jollant","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Paris\u2010Saclay University and Academic Hospital (CHU) Bic\u00eatre  Le Kremlin\u2010Bic\u00eatre France"},{"name":"Department of Psychiatry N\u00eemes Academic Hospital (CHU)  N\u00eemes France"},{"name":"Department of Psychiatry McGill University  Montreal Quebec Canada"},{"name":"MOODS Research Team, Centre de recherche en Epid\u00e9miologie et sant\u00e9 des populations (CESP), Institut national de la sant\u00e9 et de la recherche m\u00e9dicale (Inserm)  Le Kremlin\u2010Bic\u00eatre France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Cottenet","sequence":"additional","affiliation":[{"name":"Biostatistics and Bioinformatics (DIM), University Hospital Bourgogne Franche\u2010Comt\u00e9 University  Dijon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Bechraoui\u2010Quantin","sequence":"additional","affiliation":[{"name":"Biostatistics and Bioinformatics (DIM), University Hospital Bourgogne Franche\u2010Comt\u00e9 University  Dijon France"},{"name":"Gynecology, Obstetrics and Fetal Medicine University Hospital  Dijon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Rozenberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, H\u00f4pital Intercommunal de Poissy Universit\u00e9 Versailles Saint\u2010Quentin  Poissy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6442-1013","authenticated-orcid":false,"given":"Emmanuel","family":"Simon","sequence":"additional","affiliation":[{"name":"Gynecology, Obstetrics and Fetal Medicine University Hospital  Dijon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5134-9411","authenticated-orcid":false,"given":"Catherine","family":"Quantin","sequence":"additional","affiliation":[{"name":"Biostatistics and Bioinformatics (DIM), University Hospital Bourgogne Franche\u2010Comt\u00e9 University  Dijon France"},{"name":"Inserm, High\u2010Dimensional Biostatistics for Drug Safety and Genomics, CESP Universit\u00e9 Paris\u2010Saclay, Universit\u00e9 Versailles Saint\u2010Quentin, Universit\u00e9 Paris\u2010Sud  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.3550"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-005-0080-1"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1300\/J126v03n02_07"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.161711"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31823294da"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-007-0192-x"},{"key":"e_1_2_11_8_1","first-page":"237","volume-title":"6 e rapport de l\u2019Enqu\u00eate Nationale Confidentielle sur les Morts Maternelles (ENCMM), 2013\u20132015","author":"Les morts maternelles en France: mieux comprendre pour mieux pr\u00e9venir","year":"2021"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2003.09.001"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2174\/1573404052950311"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/0887044042000272921"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-200301000-00023"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674371005500407"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckx065"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494814560844"},{"key":"e_1_2_11_16_1","volume-title":"American Psychological Association task force on mental health and termination of pregnancy. 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