Associated factors with spatial variation of adolescent pregnancy in Brazil, 2014: an ecological study of spatial clusters.

Objective: To identify socioeconomic and health care determinants of spatial variation in adolescent pregnancy in Brazil in 2014.
Methods: This was a spatial ecological study having municipalities as units of analysis. Spatial linear regression was used to verify association between the fertility rate in 15-19 year-old women and socioeconomic and health variables.
Results: The adolescent fertility rate was negatively associated with higher Family Health Strategy coverage (β = -0.011 - 95%CI -0.017;-0.005), an adequate number of prenatal consultations (β = -0.122 - 95%CI -0.132;-0.224) and low average family income per capita (β = -0.104 - 95%CI -0.105;-0.103). Association was positive in relation to the Gini index (β = 7.031 - 95%CI 4.793;9.269), low income (β = 0.127 - 95%CI 0.108;0.145), higher household density (β = 6.292 - 95%CI 5.062;7.522) and less schooling (β = 0.260 - 95%CI 0.224;0.295).
Conclusion: Reduced access to primary care and lower income are associated with higher adolescent fertility rates. Poorer socioeconomic and health care indicators are associated with higher adolescent fertility rates.