背景與目的: 青少女懷孕隨之而來的生心理改變、經濟負擔及家庭關係的不協調等，進而促使青少女懷孕事件衍生許多社會及公共衛生問題。然而過去文獻指出，青少女懷孕往往處於社經劣勢並伴隨較差的健康行為，使得青少女懷孕及低社經狀況者則有較低之產檢利用及較差妊娠狀況，由此可知，青少女懷孕、社經地位與妊娠狀況彼此間有著錯綜複雜的關係，實有進一步釐清探討之必要，故本研究欲探討我國青少女懷孕社經差異之流產、生產趨勢，及醫療利用與其妊娠狀況，以期藉此可進一步了解青少女懷孕現況，得以提供輔助相關政策制訂之依據。
研究方法: 本研究使用1996-2008年的全民健保資料庫。而年齡為十歲以上未滿二十歲定義為青少女，二十歲以上未滿三十歲定義為適齡。首先先進行流產及生產率之趨勢分析，再者以T-TEST及One-way ANOVA分析青少女與適齡及其社經差異之就醫利用情形，最後以邏輯斯迴歸分析其產檢利用及妊娠狀況之相關探討。
研究結果:第一，趨勢探討部分，青少女流產、生產率如同適齡婦女有下降的趨勢。但地區人口的青少女的流產生產率卻增加。第二，就醫利用部分，低收青少女一般醫療利用居最高位，而產檢利用卻較低。而青少女地區人口產檢則是最低的。第三，產檢利用及妊娠狀況部分，青少女平均產檢次數相較於適齡歷年都有較低產檢利用，而青少女低收及地區人口之產檢利用相較於其他身分而言皆有較低利用情形。在青少女妊娠狀況部分，青少女早產或迫切生產情形、胎位異常及早期破水較高，而低收青少女之子癲前症/子癲症、早產或迫切生產、妊娠併發症之比率相較於其他身分者有較高的患病情形；另外針對青少女進一步進行迴歸分析，可發現青少女產檢越低其早產或迫切生產越高，而低收青少女相較於其他身分子癲前症/子癲症、妊娠併發症有較高之患病率。
結論: 綜觀整個研究結果，青少女產前檢查較低而妊娠狀況較差，而低收青少女在其他就醫部分是較高的，但其產檢較低且妊娠狀況較差。據此，青少女產婦及社經地位較差者是具較高不良妊娠結果的風險，這不僅是對健康、家庭或是社會層面的造成影響，更是跨領域公共衛生須整合資源即早介入改善之重要議題。

Background and Objectives: Adolescents’ pregnancy will cause their mental status changes, financial burdens, discordant in family relationship, and etc.. Therefore, many social and public health’s problems will be derived from the whole processes of adolescents’ pregnancy. The literature reviews showed that these girls were usually at poor socioeconomic status and behaved immature health behaviors. Pregnancy in teenagers or girls at poor socioeconomic status, who were seldom received the prenatal examination and had poor pregnancy status. There is a complex association among the adolescents’ pregnancy, socioeconomic status and pregnancy status and to verify them in detailed with necessity. This study aimed to investigate how the socioeconomic status influences the trend of abortion, delivery, medical utilization and pregnancy outcomes during adolescent pregnancy. Hopefully, the current situation of the adolescents’ pregnancy through this study could be better known and it could also be the basis for related policies making.
Methods: The data sources were the National Health Insurance Research database (NHIRD) from 1996 to 2008. We define “teenage group” as girls whose age is over ten and under twenty, and “the appropriate age group” as woman who aged twenties. Initially, we analyzed the trend of abortion and birth rates. Then we linked the pre- and post-medical records of the postpartum women, distinguish the difference of medical utilities between different socio-economic status and age groups by t-test and one-way ANOVA. Finally, verifying the associations between the usage of prenatal examination and the gestation status by logistic regression.
Results: First of all, for the trend of delivery and abortion, you could find both rates in adolescents decrease as that in appropriate age group. But the rates in the local population group in adolescents are highest and unexpectedly increase. Secondly, for the medical utilization, you could find low-income adolescents are the highest of all while they are much lower in prenatal examination. Moreover, the prenatal examination rate of adolescents is the lowest in local population group. Thirdly, for prenatal examination and pregnancy status, you could find the examination rate in adolescents is less than control group in every year. The adolescents who are low-income and belong to local population group, whose prenatal examination usage is less than others. Comparing the pregnancy status, the adolescents showed high rates in preterm pregnancy, abnormal fetal and premature rupture of membranes. Moreover, the low-income adolescents have higher rate for having preeclampsia /eclampsia, preterm and pregnancy complications.
Conclusions: In summary, the adolescents take less pregnancy prenatal examination, and they will have worse pregnancy outcome. However the low-income adolescents have higher rate for medical utilization but they have lower rate for prenatal examination and they have worse pregnancy outcome. Pregnant women who are adolescents or have poor socioeconomic status usually have high risk for having bad pregnant situation. This problem does not only influence deeply to the healthiness, family and society, but also be a key issue of public health for integrating all of the resource and multi-disciplines to improve this situation as soon as possible.

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http://www.nhi.gov.tw/webdata/webdata.aspx?menu=17&menu_id=660&webdata_id=2091&WD_ID=672
行政院衛生署中央健康保險局（2012年6月）。經濟弱勢協助。取自http://www.nhi.gov.tw/webdata/webdata.aspx?menu=18&menu_id=682&webdata_id=3578&WD_ID=682
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