Department of Public Health, Denver Health and Hospital Authority, Denver, Colorado 80204, USA.
J Womens Health (Larchmt). 2009 Oct;18(10):1693-9. doi: 10.1089/jwh.2008.0966.
Most sexually transmitted disease (STD) clinics focus solely on STD treatment and prevention. However, women seeking care are also at high risk for unintended pregnancy. We sought to examine the relationship between baseline demographic and clinical characteristics and incident pregnancy among women provided initial contraceptive services in an STD clinic.
Computerized record review of women attending an STD clinic who initiated contraception, were seen at least twice within a 4-year period (repeat attendees), and indicated no intention of pregnancy were included in these analyses. Associations between baseline demographic, behavioral, and clinical characteristics and incident pregnancy were assessed using multivariate logistic regression.
Among 4617 women seen from 2003 to 2006, 710 (15%) were repeat attendees and 3907 (85%) were single attendees (seen only during a single year). Among the repeat attendees, 642 (90%) indicated no interest in pregnancy, of whom 124 (19%) had a subsequent pregnancy. Using multivariate analysis and controlling for age and race/ethnicity, incident pregnancy was associated with previous pregnancy (OR 2.57, 95% CI 1.63-4.04), <or=150% federal poverty level (OR 2.22, 95% CI 1.05-4.71), and no contraceptive use at last sex (OR 1.67, 95% CI: 1.11-2.52). Incident pregnancy was not associated with educational level, sexual frequency, age of first pregnancy, number of partners, prior therapeutic abortion, or provision of effective contraception at the initial STD clinic visit.
Certain baseline characteristics identified a subset of women seen in an STD clinic that were associated with future unintended pregnancy. Targeted interventions addressing these factors are needed.
大多数性传播疾病（STD）诊所仅专注于 STD 的治疗和预防。然而，寻求治疗的女性也面临着意外怀孕的高风险。我们试图研究在 STD 诊所初次提供避孕服务的女性中，基线人口统计学和临床特征与意外怀孕之间的关系。
对在 STD 诊所就诊并接受避孕服务的女性进行计算机记录回顾，这些女性在 4 年内至少就诊 2 次（复诊患者），且表示无妊娠意向，这些患者被纳入本分析。使用多变量逻辑回归评估基线人口统计学、行为和临床特征与意外怀孕之间的关联。
在 2003 年至 2006 年间就诊的 4617 名女性中，有 710 名（15%）为复诊患者，3907 名（85%）为初诊患者（仅在单一年度就诊）。在复诊患者中，有 642 名（90%）表示无妊娠意向，其中 124 名（19%）随后怀孕。使用多变量分析并控制年龄和种族/民族，意外怀孕与既往怀孕（比值比 2.57，95%置信区间 1.63-4.04）、收入低于等于联邦贫困线 150%（比值比 2.22，95%置信区间 1.05-4.71）和上次性行为时未使用避孕措施（比值比 1.67，95%置信区间：1.11-2.52）相关。意外怀孕与教育程度、性频率、首次妊娠年龄、伴侣数量、既往治疗性流产或初次 STD 诊所就诊时提供有效避孕措施无关。
某些基线特征确定了 STD 诊所就诊女性中与未来意外怀孕相关的亚组。需要针对这些因素开展有针对性的干预措施。
