Vital signs: births to teens aged 15-17 years--United States, 1991-2012.

Background: Teens who give birth at age 15-17 years are at increased risk for adverse medical and social outcomes of teen pregnancy. Methods: To examine trends in the rate and proportion of births to teens aged 15-19 years that were to teens aged 15-17 years CDC analyzed 1991-2012 National Vital Statistics System data. National Survey of Family Growth (NSFG) data from 2006-2010 were used to examine sexual experience contraceptive use and receipt of prevention opportunities among female teens aged 15-17 years. Results: During 1991-2012 the rate of births per 1000 teens declined from 17.9 to 5.4 for teens aged 15 years 36.9 to 12.9 for those aged 16 years and 60.6 to 23.7 for those aged 17 years. In 2012 the birth rate per 1000 teens aged 15-17 years was higher for Hispanics (25.5) non-Hispanic blacks (21.9) and American Indians/Alaska Natives (17.0) compared with non-Hispanic whites (8.4) and Asians/Pacific Islanders (4.1). The rate also varied by state ranging from 6.2 per 1000 teens aged 15-17 years in New Hampshire to 29.0 in the District of Columbia. In 2012 there were 86423 births to teens aged 15-17 years accounting for 28% of all births to teens aged 15-19 years. This percentage declined from 36% in 1991 to 28% in 2012 (p <0.001). NSFG data for 2006-2010 indicate that although 91% of female teens aged 15-17 years received formal sex education on birth control or how to say no to sex 24% had not spoken with parents about either topic; among sexually experienced female teens 83% reported no formal sex education before first sex. Among currently sexually active female teens (those who had sex within 3 months of the survey) aged 15-17 years 58% used clinical birth control services in the past 12 months and 92% used contraception at last sex; however only 1% used the most effective reversible contraceptive methods. Conclusions: Births to teens aged 15-17 years have declined but still account for approximately one quarter of births to teens aged 15-19 years. Implications for public health practice: These data highlight opportunities to increase younger teens exposure to interventions that delay initiation of sex and provide contraceptive services for those who are sexually active; these strategies include support for evidence-based programs that reach youths before they initiate sex resources for parents in talking to teens about sex and contraception and access to reproductive health-care services.