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Risk of teenage pregnancy among adolescents with bipolar disorder: a cohort study of 35,398 adolescent girls

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Abstract

Teenage pregnancy is a major public health concern. However, few studies have investigated the relationship between pediatric bipolar disorder and early pregnancy, and whether bipolar disorder medications reduce the risk of early pregnancy remains unknown. In total, 3218 adolescent girls with bipolar disorder and 32,180 controls matched for age, family income, residence, and time of enrollment were enrolled in this study from 2001 to 2009. Early pregnancy, defined as pregnancy occurring in patients younger than 20 years old, was identified during the follow-up period from enrollment until the end of 2011. After adjustment for demographic data, psychiatric comorbidities, and bipolar disorder medications, adolescent girls with bipolar disorder had 20 times the risk of early pregnancy (hazard ratio [HR] = 20.63, 95% confidence interval [CI] [15.68, 27.16]) and about 25 times the risk of repeated early pregnancy (HR = 24.59, 95% CI [15.20, 39.78]) compared with those without bipolar disorder. Long-term use of both mood stabilizers (HR = 0.34, 95% CI [0.23, 0.52]) and atypical antipsychotics (HR = 0.32, 95% CI [0.20, 0.51]) was associated with a reduced risk of early pregnancy. Bipolar disorder was associated with an increased risk of early pregnancy in adolescent girls. Bipolar disorder medications reduced this risk. The results suggest that interventions targeting the vulnerable population of adolescent girls with bipolar disorder are warranted to prevent early pregnancies.

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Acknowledgements

The authors thank Mr I-Fan Hu, MA (Courtauld Institute of Art, University of London; National Taiwan University) for his friendship and support. Mr Hu declares no conflicts of interest.

Funding

The study was supported by grant from Taipei Veterans General Hospital (V111C-010, V111C-040, V111C-029), Yen Tjing Ling Medical Foundation (CI-109-21, CI-109-22, CI-110-30) and Ministry of Science and Technology, Taiwan (MOST110-2314-B-075-026, MOST110-2314-B-075-024 -MY3, MOST109-2314-B-010-050-MY3, MOST111-2314-B-075 -014 -MY2, MOST 111-2314-B-075 -013). The funding sources did not participate nor influence the study design, data collection and analysis, findings, or reporting of the current study. All the authors have no financial relationships relevant to this article to disclose.

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Authors and Affiliations

  1. Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan

    Han-Sian Yang, Ju-Wei Hsu, Kai-Lin Huang, Shih-Jen Tsai, Ya-Mei Bai, Tung-Ping Su & Mu-Hong Chen

  2. Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Ju-Wei Hsu, Kai-Lin Huang, Shih-Jen Tsai, Ya-Mei Bai, Tung-Ping Su & Mu-Hong Chen

  3. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Tzeng-Ji Chen

  4. Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Tzeng-Ji Chen

  5. Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan

    Tung-Ping Su

  6. Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan

    Tzeng-Ji Chen

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  1. Han-Sian Yang
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Contributions

MHC, JWH, and YMB designed the study. HSY and MHC analyzed the data and drafted the first version of the manuscript. SJT, KLH, TPS, and TJC performed literature search and reviewed the manuscript. All the authors contributed substantially to the manuscript, and approved the final manuscript for submission. All the authors are responsible for the integrity, accuracy, and presentation of the data.

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Correspondence to Mu-Hong Chen.

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Yang, HS., Hsu, JW., Huang, KL. et al. Risk of teenage pregnancy among adolescents with bipolar disorder: a cohort study of 35,398 adolescent girls. Eur Child Adolesc Psychiatry 32, 2001–2008 (2023). https://doi.org/10.1007/s00787-022-02029-z

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  • DOI: https://doi.org/10.1007/s00787-022-02029-z

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