Department of Community Health, Alpert Medical School of Brown University, Providence, RI, USA.
Matern Child Health J. 2012 Dec;16(9):1820-7. doi: 10.1007/s10995-011-0928-0.
Unintended pregnancy and associated behaviors may play a substantial role in the increased risk of adverse maternal and neonatal outcomes associated with teen pregnancy. We evaluate a multi-dimensional measure of pregnancy intention among pregnant adolescents and quantify the association between intention dimensions and adverse outcomes and risk behaviors. Pregnancy intention measures were examined in a cohort of 300 pregnant adolescent women. We considered 18 items assessing elements of pregnancy intention including pregnancy planning, timing, emotional response, and readiness. Latent class analysis was performed to identify dimensions of pregnancy intention. Parsimonious scores were created by minimizing the number of covariates while maintaining substantial agreement with the latent class. Associations between intention measures and prenatal care, risk behaviors, and pregnancy outcomes were quantified using multivariable logistic regression. Two constructs of pregnancy intention were identified: planning and emotional readiness. Compared with emotionally ready adolescents, adolescents categorized as not emotionally ready had an increased odds of inadequate prenatal care (OR = 2.70, 95% CI:1.27-5.72), delayed prenatal care (OR = 2.54, 95% CI:1.27-5.09), and self-reported depression at the time of the first prenatal visit (OR = 2.21, 95% CI:1.03-4.77). Pregnancy planning was not associated with adverse pregnancy risk factors or outcomes. Among pregnant adolescents, emotional readiness for pregnancy and parenting was inversely associated with known risk factors for adverse pregnancy outcomes, suggesting that emotional readiness rather than pregnancy planning may be the more pertinent intention construct for adolescents.
意外怀孕和相关行为可能在青少年怀孕相关的不良母婴结局风险增加中发挥重要作用。我们评估了一组怀孕青少年的多维妊娠意图测量，并量化了意图维度与不良结局和风险行为之间的关联。在 300 名怀孕青少年女性的队列中检查了妊娠意图措施。我们考虑了 18 项评估妊娠意图元素的项目，包括妊娠计划、时间、情绪反应和准备情况。潜在类别分析用于确定妊娠意图的维度。通过最小化协变量的数量并同时保持与潜在类别实质性一致，创建了简洁的分数。使用多变量逻辑回归量化了意图测量与产前护理、风险行为和妊娠结局之间的关联。确定了妊娠意图的两个构建：计划和情绪准备。与情绪准备充分的青少年相比，被归类为情绪准备不充分的青少年接受充分产前护理的可能性较低（OR = 2.70，95%CI：1.27-5.72），产前护理延迟（OR = 2.54，95%CI：1.27-5.09），以及首次产前就诊时自我报告的抑郁（OR = 2.21，95%CI：1.03-4.77）。妊娠计划与不良妊娠风险因素或结局无关。在怀孕的青少年中，对怀孕和育儿的情绪准备与已知的不良妊娠结局风险因素呈负相关，这表明情绪准备而不是妊娠计划可能是青少年更相关的意图结构。
