Psychosocial Predictors of Teenage Pregnancy: Roles of Self-Esteem, Study Attitude, and Family Attachment

Teenage pregnancy remains a significant public health concern in low- and middle-income countries, including the Philippines, where rural and underserved communities continue to experience persistent social and health inequities. Despite ongoing policy and programmatic efforts, adolescent fertility rates remain disproportionately high in socioeconomically disadvantaged areas. This study examined psychosocial factors associated with teenage pregnancy using a cross-sectional retrospective design. Participants were adult women aged 20 years and above who were purposively selected from barangay records in rural communities and classified as teenage mothers (first childbirth at ages 13–19) or non-teenage mothers (first childbirth at age 20 or older). A total of 441 respondents completed structured questionnaires assessing self-esteem, study attitudes, and family attachment as recalled prior to their first pregnancy. Independent-sample t-tests were conducted to examine group differences, while multivariable logistic regression was used to identify psychosocial predictors of teenage pregnancy. Results indicated that non-teenage mothers reported significantly higher self-esteem, more positive study attitudes, and stronger maternal attachment than teenage mothers (p < .001). Logistic regression analysis showed that self-esteem (OR = 0.16), study attitude (OR = 0.66), and maternal attachment (OR = 0.20) were significant protective factors against teenage pregnancy. The model demonstrated robust predictive performance, with an overall classification accuracy of 82% and high sensitivity in identifying teenage mothers. These findings underscore the importance of psychosocial and relational factors in shaping adolescent reproductive outcomes within structurally constrained rural contexts. Strengthening adolescents’ self-esteem, sustaining school engagement, and promoting supportive mother–child relationships may be critical components of preventionoriented strategies to reduce teenage pregnancy, particularly in rural and resource-constrained settings.

Adolescent reproductive health

1. Bowlby, J. (2008). A secure base: Parent–child attachment and healthy human development. Basic Books. [Google Scholar] [Crossref]

2. Burgess, R. A., Jeffery, M., Odero, S. A., Rose-Clarke, K., & Devakumar, D. (2022). Overlooked and unaddressed: A narrative review of mental health consequences of child marriages. PLOS Global Public Health, 2(1), e0000131. https://doi.org/10.1371/journal.pgph.0000131 [Google Scholar] [Crossref]

3. Cabigon, J. V. (2020). Teenage pregnancy in the Philippines: Trends, correlates, and policy challenges. Philippine Population Review, 19, 1–19. [Google Scholar] [Crossref]

4. Cananua-Labid, S. A., de Paz-Silava, S. L. M., Quilatan, J. A. M., Cabaguing, A. M., & Bajado, J. C. (2024). Awareness, availment, and satisfaction on various health services among residents of a rural community in Samar, Philippines: A mixed methods study. Acta Medica Philippina, 58(23). https://doi.org/10.47895/amp.vi0.8344 [Google Scholar] [Crossref]

5. Department of Health. (2019). Philippine health statistics. https://doh.gov.ph/statistics/philippine_health_statistics [Google Scholar] [Crossref]

6. Diabelková, J., Rimárová, K., Dorko, E., Urdzík, P., Houžvičková, A., & Argalášová, Ľ. (2023). Adolescent pregnancy outcomes and risk factors: A systematic review. International Journal of Environmental Research and Public Health, 20(5), 4113. https://doi.org/10.3390/ijerph20054113 [Google Scholar] [Crossref]

7. Erfina, E., Widyawati, W., McKenna, L., Reisenhofer, S., & Ismail, D. (2019). Adolescent mothers’ experiences of the transition to motherhood: An integrative review. International Journal of Nursing Sciences, 6(2), 221–228. https://doi.org/10.1016/j.ijnss.2019.03.013 [Google Scholar] [Crossref]

8. Garcia Saiz, E., Sarda, V., Pletta, D. R., Reisner, S. L., & Katz-Wise, S. L. (2021). Family functioning as a protective factor for sexual risk behaviors among adolescents. Archives of Sexual Behavior, 50(8), 3023– 3033. https://doi.org/10.1007/s10508-021-02006-6 [Google Scholar] [Crossref]

9. Hirschi, T. (1969). Causes of delinquency. University of California Press. [Google Scholar] [Crossref]

10. Houtepen, L. C., Heron, J., Suderman, M. J., Fraser, A., Chittleborough, C. R., & Howe, L. D. (2020). [Google Scholar] [Crossref]

11. Associations of adverse childhood experiences with educational attainment and adolescent health: Background mechanisms and policy implications. PLOS Medicine, 17(3), e1003031. https://doi.org/10.1371/journal.pmed.1003031 [Google Scholar] [Crossref]

12. Karababa, A. (2022). Parental attachment, loneliness, and self-esteem among adolescents. Current Psychology, 41(10), 6655–6665. https://doi.org/10.1007/s12144-020-01071-w [Google Scholar] [Crossref]

13. Maqbool, M., Khan, M., Mohammad, M., Adesina, M. A., & Fekadu, G. (2019). Awareness about reproductive health in adolescents and youth: A review. Journal of Applied Pharmaceutical Sciences and Research. [Google Scholar] [Crossref]

14. Masud, H., Ahmad, M. S., Cho, K. W., & Fakhr, Z. (2019). Parenting styles and aggression among young adolescents: A systematic review of literature. Community Mental Health Journal, 55(7), 1015–1030. https://doi.org/10.1007/s10597-019-00414-1 [Google Scholar] [Crossref]

15. Mohr, R., Carbajal, J., & Sharma, B. B. (2019). The influence of educational attainment on teenage pregnancy in low-income countries: A systematic literature review. Journal of Social Work in the Global Community, 4(1), 2–12. [Google Scholar] [Crossref]

16. Neal, S., Channon, A. A., & Chintsanya, J. (2018). The impact of young maternal age at birth on neonatal mortality: Evidence from 45 low- and middle-income countries. BMJ Open, 8(2), e020224. https://doi.org/10.1136/bmjopen-2017-020224 [Google Scholar] [Crossref]

17. Olorunsaiye, C. Z., Degge, H. M., Ubanyi, T. O., Achema, T. A., & Yaya, S. (2022). “It’s like being involved in a car crash”: Teen pregnancy narratives of adolescents and young adults in Jos, Nigeria. International Health, 14(6), 562–571. https://doi.org/10.1093/inthealth/ihac021 [Google Scholar] [Crossref]

18. Philippine Statistics Authority. (2017). Women and men in the Philippines. https://psa.gov.ph/content/women-and-men-philippines [Google Scholar] [Crossref]

19. Philippine Statistics Authority. (2023). 2022 National Demographic and Health Survey: Key indicators— Teenage pregnancy. https://psa.gov.ph [Google Scholar] [Crossref]

20. Philippine Statistics Authority–CAR. (2023, February 7). Special release: 2022 National Demographic and Health Survey (NDHS) key indicators: Teenage pregnancy. https://rssocar.psa.gov.ph [Google Scholar] [Crossref]

21. Pueyo, J. T. (2022). Moms too soon: Status and challenges of teenage mothers—Implications for extension. Journal of International Women’s Studies, 23(6), 1–15. [Google Scholar] [Crossref]

22. Racz, S. J., & McMahon, R. J. (2011). The relationship between parental knowledge and monitoring and adolescent sexual risk behavior: A meta-analysis. Journal of Youth and Adolescence, 40(3), 421–435. https://doi.org/10.1007/s10964-010-9589-3 [Google Scholar] [Crossref]

23. Ravitz, P., Maunder, R., Hunter, J., Sthankiya, B., & Lancee, W. (2010). Adult attachment measures: A 25-year review. Journal of Psychosomatic Research, 69(4), 419–432. https://doi.org/10.1016/j.jpsychores.2009.08.006 [Google Scholar] [Crossref]

24. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton University Press. [Google Scholar] [Crossref]

25. Sezgin, A. U., & Punamäki, R. L. (2020). Impacts of early marriage and adolescent pregnancy on mental and somatic health: The role of partner violence. Archives of Women’s Mental Health, 23(2), 155–166. https://doi.org/10.1007/s00737-019-00992-1 [Google Scholar] [Crossref]

26. Singh, D., Manna, S., Barik, M., Rehman, T., Kanungo, S., & Pati, S. (2023). Prevalence and correlates of low birth weight in India: Findings from National Family Health Survey 5. BMC Pregnancy and Childbirth, 23(1), 112. https://doi.org/10.1186/s12884-022-05230-8 [Google Scholar] [Crossref]

27. United Nations Population Fund. (2022). Adolescent pregnancy: Global trends and impacts. https://www.unfpa.org [Google Scholar] [Crossref]

28. World Health Organization. (2019). Philippines: WHO statistical profile. https://www.who.int/gho/countries/phl.pdf [Google Scholar] [Crossref]

29. Zamiri-Miandoab, N., Kamalifard, M., & Mirghafourvand, M. (2022). Relationship of self-esteem with body image and attitudes toward motherhood and pregnancy. Journal of Psychosocial Nursing and Mental Health Services, 60(10), 29–37. https://doi.org/10.3928/02793695-20220906-03 [Google Scholar] [Crossref]

• Tribal Child Nutrition and Health in District of Sundargarh: A Public Health Review of ICDS Intervention
• Knowledge, Attitudes and Practices Towards Prostate Cancer Screening Amongst Men Aged 40-60 Years in The Buea Health District: A Cross-Sectional Study
• Compliance with JCI Protocols: A Focus on Employee Safety
• Influence and Involvement of Teachers in Menstrual Hygiene Management of Female Secondary School Students in Kogi State, Nigeria
• A Critical Evaluation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana in Bihar