by pregnant and parenting adolescent women and their families.Given the importance of maternal oral health to general and preg-nancy health andwell-being, all of these factors should be consideredwhen delivering care, designing future research and planning policyrelated to the priority population, their children, and families. Healthcare providers should explore the use of alternate oral health servicesamong adolescents within the context of culture, acknowledge thosesources if they exist, and integrate them into professional care ifdeemed safe and appropriate.Sources of Support: Sigma Theta Tau Epsilon Theta Chapter Re-search Award St. David’s Community Health Foundation Dental Pro-gram The University of Texas Center for Women and Gender StudiesResearch Award.

184.

RELATIONSHIP BETWEEN RAPID REPEAT PREGNANCY ANDDEPRESSION IN LOW-INCOME, MINORITY TEEN MOTHERSKathleen Conroy, MD, Talia Engelhart, MPH, Paul Arandia, MPH,Peter Forbes, MA, Joanne Cox, MD, MPH.

Children’s Hospital Boston

Purpose: Although U.S. teen pregnancy rates have declined, repeatpregnancy has shown a slower downward trend, with national ratesof rapid repeat pregnancy (RRP – defined as another pregnancywithin 12months of the index child) remaining around 20%. Previousresearch has demonstrated a connection between depression in teenmothers and rapid repeat pregnancy, however, this finding has beenlimited by cross-sectional methodology which has not captured de-pression in a longitudinal fashion. We sought to better understandtemporal relationships between depression and rapid repeat preg-nancy among a group of low-income, urban teen mothers attendingan intensive medical and social service parenting intervention.Methods: Participants were 152 teen mothers attending a teen-totclinic where they received medical care, social services, and parent-ing/life skills education. The majority (80.3%) received Medicaid.Ethnicity was 42% African American, 56% Latino, and 7% White. Pro-spective datawere collected using a self-administered computerizedquestionnaire at intake and 12 months post-partum that includedquestions on demographics, housing, school, financial support, rela-tionship status and social risk factors. Depressive symptoms weremeasured with an electronic version of the 20 question Center forEpidemiological Studies Depression Scale for Children (CESD-C); RRPstatus was determined from chart review. Data were analyzed usingchi-square or Fisher’s exact test for categorical variables and t-testsfor continuous variables.Results: Ninety-four of the teen mothers completed the CESD-C atbaseline and at 12 months. At enrollment, teen mothers’ mean agewas 17.9 (n � 94; SD 1.0) years; children averaged 0.9 (SD 1.4)months. Seventy-one percent of teenmothers reported that father ofbabies (FOBs) offered financial support, and 19% lived with the FOB.Twenty-five percent of mothers reported being employed and 82%were in school or a GED program or had graduated. Sixty percentlivedwith one or both of their parents. At one year follow-up18 (19%)had experienced RRP. Baseline CESD-C scores of the two groupswerenot significantly different (RRPs: 16.2; SD: 11.3 vs nonRRPs: 13.5; SD:10.1; p � .29). However, at 12-month follow-up, those with an RRPhad significantly higher CESD-C scores than thosewho had not expe-rienced an RRP (23.5; SD: 15.7 vs 15.0; SD: 12.1; p � .01).Conclusions: Although depressive symptoms at intake were notpredictive of a subsequent RRP, teen mothers who did experience anRRP were more likely to report significant depressive symptoms atone year post-partum compared to teenswithout RRP. This finding is

consistent with prior research demonstrating a seeming dose-responserelationship between the number of pregnancies in the teenage yearsand worsening outcomes for children of teen parents. Our studyhighlights the importance of periodic behavioral health screeningand provision ofmental health services for teenmothers, particularlyif they have experienced another pregnancy. It also emphasizes theimportance of supporting teen mothers in parenting each of theirchildren, not only their first. Continued focus onmental health couldhelp mitigate the negative outcomes for subsequent children of teenparents.Sources of Support: None.

185.

“SO I’M PREGNANT, NOWWHAT?” PRIMARY CARE ANDREPRODUCTIVE HEALTH FOLLOW-UP OF ADOLESCENT WOMENShamieka Virella Dixon, MD, Jane Ogbonna, MSW,Mary Lou Rosenblatt, MS, Carrie Vick, MSW, Maria Trent, MD, MPH,FSAHM.

Johns Hopkins University School of Medicine

Purpose: As funding for national pregnancy prevention programs,alternative schools and teen tot clinics decline, primary care clinicsincreasingly serve as a safety net for pregnant adolescent. This studyexamined provider testing and counseling practices of newly diag-nosed pregnant adolescents and their return to primary care afterdelivery, termination or miscarriage.Methods: We used ICD-9 diagnosis codes of pregnancy, positivepregnancy test, spontaneous abortion variations, bleeding, and infec-tions in pregnancy to identify 74 adolescent women in 2010. Wereviewed electronic medical records using standardized data extrac-tion forms and recorded psychosocial history, pregnancy counseling,sexually transmitted infection (STI) testing, pregnancy decision, andreturn to primary care. Chi-squared analyses were used to examinedifferences between girls that returned to primary care and those lostto follow-up. This analysiswas approvedby the JohnsHopkins Schoolof Medicine’s Institutional Review Board.Results: The sample included 74 African Americanwomen at a largeurban academic center in Baltimore, Maryland, mean age 17.8 years(SD 2). The mean estimated gestational age at diagnosis was 10weeks (SD 8) and age of the father of the babywas 19.2 years (SD 2.7).Eleven percent of patients were uninsured and this was the firstpregnancy for 58% of adolescents. Thirty-five percent had a history ofan STI and an additional 11% had a history of pelvic inflammatorydisease. At the time of diagnosis, 51 (69%) were tested for Gonorrheaand Chlamydia and 10% were positive for Chlamydia; there were noGonorrhea infections. Twenty-nine (39%) were screened for HIV andSyphilis and one patient tested positive for HIV. Seventy-two percentof patients ultimately carried their pregnancy to term, however, only37.6% had documented counseling regarding healthy diets and absti-nence from tobacco and drugs. Thirty-eight percent of patients didnot return to primary care after they delivered, miscarried, or termi-nated, and the mean (SD) time to return was 5.3 months (3.4). Of theadolescents that returned to primary care, 37% had a repeat preg-nancy 12-24months after their indexpregnancy and21%were not oncontraception at their last clinic visit. The mean (SD) age of adoles-cents that returned to care was 17 years (1.8) compared to 18.8 years(2) for those that did not return (p� .00). Thiswas the first pregnancyfor 70% of girls that returned to primary care compared to only 40% ofthose thatwere lost (p� .05). Therewere no significant differences inrisk behaviors, STIs, or contraceptive use.Conclusions: Primary care providers offer a haven for adolescentwomen to address issues of physical and reproductive health needs,

S109Poster Abstracts / 52 (2013) S21–S113