Unmarried Youth Pregnancy, Outcomes, and Social Factors in China: Findings From a Nationwide Population-Based Survey

Introduction: Early pregnancies and their poor reproductive outcomes remain increasing concerns. Aim: This study aims to investigate the pregnancy rate and outcomes and to identify social factors associated with pregnancy among Chinese unmarried youths aged 15-24 years. Methods: Data were obtained from the Survey of Youth Access to Reproductive Health in China, and 11,076 unmarried female youths were analyzed. Prevalence of pregnancy by various demographic and socioeconomic characteristics was calculated. Univariate and multivariable logistic regression models were used to identify factors associated with pregnancy. Main Outcome Measure: The main outcome is pregnancy among unmarried female youths during their lifetime. Results: Among 11,076 female youths, 501 individuals reported 697 premarital pregnancies during their lifetime until the survey was conducted, approximately 62.9 (95% CI: 58.5-67.6) pregnancies per 1,000 female youths. Older age group (odds ratio [OR] = 4.49; 95% CI = 3.60-5.59), low education levels (primary school and below: OR = 1.78, 95% CI = 1.33-2.37; junior and senior high school: OR 1.44, 95% CI = 1.15-1.80), living in non-eastern regions (central: OR 1.34, 95% CI = 1.06-1.68; west: OR 1.62, 95% CI = 1.28-2.04), cigarette smoking (OR 3.60, 95% CI = 2.76-4.70), alcohol drinking (OR 1.59, 95% CI = 1.28-1.97), from family with mother's education of primary school and below (OR 1.65, 95% CI = 1.11-2.46), and the bottom economic status (OR 1.48, 95% CI = 1.14-1.91) were associated with higher risk of premarital pregnancy among female youths. Conclusion: The findings justify the national concern for pregnancy among unmarried youth in China. Strategies to improve sexual education in school and family, to enhance the reproductive services for youth, and to increase public awareness of the reproductive health of young people were warranted. Copyright (C) 2019, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.