Descriptive characteristics of study sample.

Teenage pregnancy remains a critical issue in Kenya, with 15% of girls aged 15–19 having been pregnant. Counties in western Kenya experience high teenage pregnancy rates (22–30%) along with high HIV prevalence and widespread poverty. Long-term consequences of teenage pregnancy have been documented in high-income countries, but evidence from the Global South is lacking. Here, we examined the association between teenage pregnancy and adult socio-economic functioning in western Kenya using cross-sectional survey data from Migori County, Kenya. We categorized women into three groups: adult mothers (first child ≥20 years), teenage mothers to 1 child (had 1 child before age 20), and teenage mothers to 2 + children (had 2 or more children before age 20). We then compared adult socioeconomic and health outcomes of these groups. We found that among 6,089 mothers, 45.2% had their first child during adolescence. Compared to adult mothers, teenage mothers were significantly less likely to complete primary education: a 12.2 percentage point (pp) reduction (95% CI: -14.9, -9.4) among teenage mothers to 1 child and 27.6 pp reduction (95% CI: -31.4, -23.8) among teenage mothers to 2 + children. Teenage mothers were also more likely to have loans and experience food insecurity. The risk of experiencing the death of a child increased from 3.4% among adult mothers to 15.3% among teenage mothers to 2 + children, a 4.5-fold increase (p