Trends and factors related to adolescent pregnancies: an incidence trend and conditional inference trees analysis of northern Nicaragua demographic surveillance data

Background We aimed to identify the 2001–2013 incidence trend, and characteristics associated with adolescent pregnancies reported by 20–24-year-old women. Methods A retrospective analysis of the Cuatro Santos Northern Nicaragua Health and Demographic Surveillance 2004–2014 data on women aged 15–19 and 20–24. To calculate adolescent birth and pregnancy rates, we used the first live birth at ages 10–14 and 15–19 years reported by women aged 15–19 and 20–24 years, respectively, along with estimates of annual incidence rates reported by women aged 20–24 years. We conducted conditional inference tree analyses using 52 variables to identify characteristics associated with adolescent pregnancies. Results The number of first live births reported by women aged 20–24 years was 361 during the study period. Adolescent pregnancies and live births decreased from 2004 to 2009 and thereafter increased up to 2014. The adolescent pregnancy incidence (persons-years) trend dropped from 2001 (75.1 per 1000) to 2007 (27.2 per 1000), followed by a steep upward trend from 2007 to 2008 (19.1 per 1000) that increased in 2013 (26.5 per 1000). Associated factors with adolescent pregnancy were living in low-education households, where most adults in the household were working, and high proportion of adolescent pregnancies in the local community. Wealth was not linked to teenage pregnancies. Conclusions Interventions to prevent adolescent pregnancy are imperative and must bear into account the context that influences the culture of early motherhood and lead to socioeconomic and health gains in resource-poor settings.