Stressful life events and the risk of unintended pregnancy: Findings from a national longitudinal study


Hall, Kelli Stidham; Richards, J. R.; Rentmeester, S. T.; & Harris, K. M. (2018). Stressful life events and the risk of unintended pregnancy: Findings from a national longitudinal study. American Public Health Association. San Diego, CA.


Objective: We examined the effects of early stressful life events (SLEs) on rates of unintended first pregnancy, including differential effects by race/ethnicity and socioeconomic status, among a national longitudinal cohort of young women. Methods: We drew upon 15-years of data from 8,810 adolescent and young adult females in the National Longitudinal Study of Adolescent to Adult Health. Using 40 different SLEs reported across childhood and adolescence, we created an additive SLE index score, whereby higher scores indicated greater SLE experiences. We employed Cox proportional hazard models, including models stratified by racial/ethnic and socioeconomic groups, to estimate the effects of SLE scores on time to first pregnancies reported as unintended, controlling for time-varying sociodemographic, health and reproductive covariates. Results: Among all women, a 1-unit increase in SLE scores was associated with an increased rate of unintended first pregnancy (adjusted Hazard Ratio 1.11, 95% Confidence Interval=1.04-1.17). In stratified models, higher SLE scores were associated with increased rates of unintended first pregnancies among African-American (aHR=1.12, CI=1.01-1.25), Asian (aHR 1.69, CI=1.26-2.26), and White women (aHR=1.12, CI=1.03-1.22) and women in the lowest ($0-$19,999; aHR=1.21, CI = 1.03-1.23) and highest (>$75,000; aHR=1.36, CI=1.12-1.66) income categories, but not among the other sociodemographic groups. Conclusion: Greater exposure to SLEs during childhood and adolescence increased the risk of unintended first pregnancy overall, but with associations having greatest impact on certain sub-groups of women. Our ongoing research aims to further elucidate the role of social stress in shaping reproductive health outcomes and disparities in the United States.



The authors are listed according to the annual report given to Add Health by Kelli Hall. However, the APHA records have the authors as Kelli Hall, Jennifer Beauregard, Shelby Rentmeester, and Kathleen Harris

Reference Type

Conference proceeding

Book Title

American Public Health Association


Hall, Kelli Stidham
Richards, J. R.
Rentmeester, S. T.
Harris, K. M.

Year Published


City of Publication

San Diego, CA

Reference ID