Elsevier

Women's Health Issues

Volume 21, Issue 2, March–April 2011, Pages 110-116
Women's Health Issues

Original article
Adolescent Pregnancy Desire and Pregnancy Incidence

https://doi.org/10.1016/j.whi.2010.09.004Get rights and content

Abstract

Background

Research has suggested the importance of pregnancy desire in explaining pregnancy risk behavior among adolescent females. Much of the literature, however, uses cross-sectional study designs to examine this relationship. Because bias may strongly influence these results, more prospective studies are needed to confirm the relationship between pregnancy desire and pregnancy incidence over time.

Methods

Nonpregnant adolescents aged 14- to 19 years (n = 208) completed baseline interviews and interviews every 6 months thereafter for 18 months. Logistic regression was used to examine demographic and psychosocial correlates of pregnancy desire. Cox regression analysis was used to determine whether pregnancy desire predicted pregnancy incidence over time after controlling for potential confounders.

Results

Twenty-four percent of participants either desired pregnancy or were ambivalent toward pregnancy in the next year. Pregnancy desire was associated with older age, relationship duration of <6 months, and greater perceived stress. After accounting for potential confounders, pregnancy desire doubled the risk of becoming pregnant over the 18-month follow-up period (relative risk, 2.00; 95% confidence interval [CI], 0.99–4.02). Additionally, a heightened risk for pregnancy was found among those who expressed some desire for pregnancy and who were not in school compared with those who expressed no desire for pregnancy and who were in school (relative risk, 4.84; 95% CI, 1.21–19.31).

Conclusion

Our analysis reinforces the importance of evaluating pregnancy desire among sexually active adolescent females. Interventions should target young women in new romantic relationships and who are not in school to improve pregnancy prevention efforts. Additionally, improving coping abilities may help to reduce feelings of pregnancy desire among adolescent females.

Section snippets

Introduction and Background

Since the 1990s, the United States has experienced significant declines in teenage pregnancy and birth rates. Between 1991 and 2005, birth rates among women 15 to 19 years old dropped 34% from 61.8 to 40.5 births per 1,000 women. More recently, however, national data have suggested increases in the annual rate and number of births to teenage women. Over 445,000 babies were born to young women 15 to 19 years old in 2007 alone (Hamilton, Martin, & Ventura, 2009).

It has been commonly assumed that

Sample

Participants were adolescent females recruited through 10 hospital clinics, community health care centers, and high school-based clinics in New Haven, Bridgeport, and Hartford, Connecticut. These three cities have the highest rates of teenage pregnancy, HIV/AIDS, and sexually transmitted diseases in the state (Connecticut Department of Public Health, 2006). Between June 1998 and March 2000, adolescent women were approached in the clinic waiting rooms by study staff, referred by an enrolled

Participant Characteristics

Participant demographic and psychosocial characteristics at baseline are shown in Table 1. The mean age of participants was 17.2 years (standard deviation, 1.46). Approximately 40% were non-Hispanic black, 33% were Hispanic, and 16% non-Hispanic White. Most were still in school and not working at baseline. Approximately one third of participants were involved in relationships lasting longer than 1 year. Seventy-six percent of participants disagreed with the statement, “You would like to get

Discussion

Approximately 24% of participants reported feelings of desire or ambivalence toward pregnancy within the next year. Our analysis demonstrates that some desire for pregnancy in this sample of adolescents is significantly associated with pregnancy incidence over the 18-month follow-up period. This study, therefore, is among the first to suggest that expressions of desire for pregnancy indicate higher risk for subsequent pregnancy among a racially and ethnically diverse sample of young women.

Ms. Sipsma's research interests include adolescent reproductive health and maternal and child health more broadly, with a focus on both domestic and international settings.

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    Ms. Sipsma's research interests include adolescent reproductive health and maternal and child health more broadly, with a focus on both domestic and international settings.

    Dr. Ickovics' research lies at the intersection between public health and psychology. She investigates the interplay of the complex psychological, medical, and social factors that influence the health of the person and of the community.

    Ms. Lewis' areas of interest lie in adolescent pregnancy, reproductive and behavioral health, and HIV prevention.

    Dr. Ethier's research has included psychosocial, behavioral, organizational and clinical factors related to women's health, maternal health and adolescent sexual and reproductive health.

    Dr. Kershaw's research revolves around the intersection of sexual, reproductive, and maternal child health in young women, men, and couples.

    Supported by Award Number T32MH020031 from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH or the NIH.

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