At a time when the number of teens having babies in the Mountain State remains higher than the national average, maternal and child health researchers at West Virginia University found these infants have a lower birth weight and are smaller for their gestational age compared to those born to adults.
"We used the most current data and the findings underscore a significant issue in the state," said Amna Umer , associate professor in the WVU School of Medicine Department of Pediatrics . "The risk of teen birth is multifactorial. This study highlights the role of social, geographical and educational factors offering crucial insights for policymakers to expand comprehensive, evidence-based teen pregnancy prevention education and birth control access for at-risk teens."
To conduct the study, researchers examined data from 2018 to 2023 provided by Project Watch. The system in place at West Virginia hospitals collects information on all births in their facilities. Of the 86,447 live births, 5,310 — or 6.15% — were born to teenage mothers. The national figure for teen births was 1.36% in 2022. Rural counties in the state had the highest percentages. In Pendleton County, the rate more than doubled to 14.38%. Boone, Mercer and Hardy counties were at 10% or higher. Monongalia County had the lowest instances at 2.76%.
The research, which aimed to examine the relationship between teen births and adverse infant outcomes, reaffirmed earlier work showing teenage mothers are less likely to have adequate prenatal care.
"Teenage mothers are a vulnerable population and there really isn't a lot of research out there, especially on those living in rural areas," said Rylee Childers, a third-year medical student from Morgantown and corresponding author of the study. "Our research identifies the hurdles that come with being a teenage mom and that's important to not just people in rural areas, but also their primary care physicians and people in the medical field."
Childers said geographic access to health care and lack of transportation could play into why teens make fewer prenatal visits.
"There are some people in rural areas that have to drive three to four hours to see their obstetrician," she said. "Additionally, a lot of teenage moms can't drive yet. So, another adult would have to take off work which might be difficult if they work two jobs. There are a lot of different factors that maybe not everybody realizes because they're not familiar with that population."
The study points to other research suggesting that since most teen pregnancies are unintended, health care providers could play a key role in contraception counseling, health care navigation and confidential care.
"I really hope the study starts a conversation about rural health care as a whole and especially about access to care and resources," Childers said.
In addition to the large and persistent rural-urban disparities in teen birth rates in the state, researchers found teenage pregnancies were more likely to occur among those who receive Medicaid and among minority racial groups.
The study was published in the Journal of Pediatric and Adolescent Gynecology. Childers and colleague Alexandra Richmond, a third-year medical student from Beckley, were selected to present findings at the 2024 West Virginia Rural Health Conference.
"Working on this study opened my eyes to the entire process of research and understanding the health care disparities of the rural population as a whole," said Childers who plans to continue her career as a rural OB/GYN physician. "It makes me think about how I can be a better provider for my patients."
Also contributing to the study were Candice Lefeber , project manager, Division of Pediatric Neonatal and Newborn Medicine; Dr. Timothy Lefeber , associate professor in the School of Medicine Department of Pediatrics; Dr. Collin John , associate professor and chief of the Division of General Pediatrics; and Christa Lilly , associate professor in the WVU School of Public Health Department of Epidemiology and Biostatistics .
Umer is continuing related studies that explore substance use, especially cannabis and vaping, among expectant teen mothers to evaluate impacts on their health as well as their children's.
