{
  "abstract": "Background Teenage pregnancy remains a public health challenge. They are associated with poor health outcomes for both mothers and offspring. Teenage mothers are at risk of pre-eclampsia and pregnancies result in higher rates of pre-term birth and infant mortality. In Ecuador, approximately one in four children is born to an adolescent mother with 83.9 adolescents livebirths per 1000 population, contrasting with rates in UK=11.8 and US=17.2. Little is known about inequalities in the rates within Ecuador. The aim is to assess socioeconomic inequalities in teenage pregnancy using area-based deprivation measures in Ecuador.Methods This study uses data from the 2010 Ecuadorian census at the census tract level (N=40,628). Teenage pregnancy is defined as the percentage of women who experience first pregnancy between 12–18 years of age. Socioeconomic position was measured using three different deprivation indices adapted to the Ecuadorian context (Townsend, Carstairs, and the Ecuadorian Deprivation Index-EDI), based on census tracts containing on average 354 residents. The indices were categorised into population-weighted quintiles using the resulting index scores. Inequalities in teenage pregnancy were assessed using the absolute gap between most and least deprived (D), the relative gap or ratio (R), the slope index of inequality (SII), and the relative index of inequality (RII). All statistical analyses were performed using R software.Results The proportion of teenage pregnancies in Ecuador was 23.29% and increased from 12.18% in the least deprived to 30.55% in the most deprived areas (based on census tracts and EDI). Inequalities were evident using all measures of inequalities for the three deprivation indices. For the absolute difference, it was 18.37 points for EDI, 19.45 for Townsend, and 21.72 for Carstairs. Comparing the ratios between the highest and lowest deprivation quintiles, the relative gap was 2.51 for EDI, 2.5 for Townsend, and 2.8 for Carstairs. The SII of 23.44 (15.6–31.28) and the RII of 3.03 (1.91–4.79) showed higher levels of inequality for the most deprived quintiles using EDI. For Townsend, the results were 24.4 (21.57–27.23) for SII and 3.2 (2.69–3.81) for RII. Carstairs presented the highest measures, SII of 26.74 (24.22–29.25) and RII of 3.69 (3.03–4.5).Conclusion Despite using area-based measures of socioeconomic status, there are clear inequalities in teenage pregnancy in Ecuador. The inequality gradient is evident regardless of the deprivation measure used. The results can inform policy makers where to target and tailor interventions to alleviate teenage pregnancy in Ecuador.",
  "authors": [
    {
      "affiliations": [
        "MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK",
        "Master of Research Program in Health Sciences, International University of Ecuador, Quito, Ecuador"
      ],
      "name": "Diego Andrade Ortiz"
    },
    {
      "affiliations": [
        "MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK"
      ],
      "name": "Ruth Dundas"
    },
    {
      "affiliations": [
        "MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK"
      ],
      "name": "Jonathan R Olsen"
    },
    {
      "affiliations": [
        "Infection and Immunity Research Institute, City St George’s, University of London, London, UK"
      ],
      "name": "Irina Chis Ster"
    }
  ],
  "title": "P17 Socioeconomic health inequalities in teenage pregnancy in Ecuador: a population-based study",
  "uid": "8fb7769f-a150-5605-bb65-f7e700e71088"
}