Adolescent Mental Health, Contraceptive Knowledge, and Teen Pregnancy Risk: A Systematic Review
Bibliographic record
Abstract
Background: Adolescent depressive and anxiety symptoms may erode motivation and problem-solving needed for timely contraception, while online information quality is uneven. We synthesized evidence linking mental health, contraceptive knowledge/access, and teen pregnancy risk. Methods: Following PRISMA-2020, we searched PubMed, Embase, and Scopus to 7 July 2025 for primary studies including adolescents that measured validated mental health symptoms or psychiatric settings and reported contraceptive knowledge/access/behavior and/or teen pregnancy outcomes. Two reviewers screened/extracted data; risk of bias was appraised with the Newcastle–Ottawa Scale and ROBINS-I. Given heterogeneity, we conducted narrative synthesis. Results: Six U.S.-based studies met the criteria, spanning community colleges, a national cohort, school surveillance, psychiatric inpatient care, and pediatric emergency departments (samples: n = 143 to weighted N = 29,755). Depressive symptoms were associated with contraception access (adjusted odds ratio [aOR] 1.58, 95% CI 1.27–1.96) and anxiety/stress with similar risk (aOR 1.46, 1.17–1.82). A first depressive episode in the same year as sexual debut increased teenage pregnancy hazard (adjusted hazard ratio 2.70, 1.15–6.34). School surveillance showed mental health indicators correlated with contraception non-use at last sex (odds ratios 1.78–2.71). Among psychiatric inpatients, not knowing where to obtain contraception and access difficulties strongly predicted interest in information (aOR 2.96–3.33) and initiation (aOR 2.85–4.72). In a pediatric emergency department trial, same-day initiation occurred in 26.8% versus 3.1% under usual care. Conclusions: Evidence directly linking adolescent mental health symptoms to teen pregnancy is limited (one study), whereas multiple studies show associations with contraception knowledge/access and delayed or non-use, suggesting plausible indirect pathways to pregnancy risk. These findings support hypothesis-generating, integrated approaches and highlight the need for studies with teen pregnancy endpoints.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".