Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Rua Do Colégio Novo, 3000-115, Coimbra, Portugal.
Psychological Intervention Unit of the Maternity Doctor Daniel de Matos, Centro Hospitalar E Universitário de Coimbra, EPE, Coimbra, Portugal.
J Prim Prev. 2021 Aug;42(4):385-407. doi: 10.1007/s10935-021-00637-0. Epub 2021 May 31.
In this study, we describe the relative contributions of and interactions between individual risk factors associated with ineffective pregnancy prevention among female adolescents in Portugal. Our sample consisted of 856 sexually experienced female adolescents (10-19 years) who did not intend to become pregnant. Of these, 379 were pregnant, and the residual (477) had never been pregnant. We used classification tree analysis to describe the interplay among a set of established sociodemographic, familial, reproductive, and relationship factors as predictors of ineffective pregnancy prevention. The tree model showed good predictive properties. Seven profiles predicted one-half to all the cases of ineffective pregnancy prevention. Ineffective pregnancy prevention was predicted by adolescents' grade level and different combinations of variables, specifically female age, age at the time of first sexual intercourse, religious beliefs, place of residence, maternal pregnancy before age 20, household structure in childhood, and partner's age difference. According to our findings, limiting assessments to the cumulative presence of risk factors may be insufficient to accurately identify adolescents at elevated risk of unwanted pregnancy, as the impact of any given risk factor may vary according to other factors. Our findings may contribute to the development of a risk assessment tool that may support healthcare providers' efforts to provide individualized risk assessment for adolescent patients and, thus, to better support pregnancy prevention.
在这项研究中，我们描述了与葡萄牙青春期女性妊娠预防无效相关的个体风险因素的相对贡献和相互作用。我们的样本包括 856 名有性经验的青春期女性（10-19 岁），她们不打算怀孕。其中 379 人怀孕，剩余的 477 人从未怀孕过。我们使用分类树分析来描述一组既定的社会人口学、家庭、生殖和关系因素之间的相互作用，这些因素是预测妊娠预防无效的预测因子。树模型显示出良好的预测性能。七个特征预测了一半到所有妊娠预防无效的病例。妊娠预防无效可由青少年的年级水平和不同变量组合来预测，具体变量包括女性年龄、首次性行为时的年龄、宗教信仰、居住地、母亲 20 岁前怀孕、童年时的家庭结构和伴侣的年龄差异。根据我们的发现，仅评估风险因素的累积存在可能不足以准确识别处于意外怀孕高风险的青少年，因为任何特定风险因素的影响可能因其他因素而异。我们的研究结果可能有助于开发一种风险评估工具，以支持医疗保健提供者为青少年患者提供个性化风险评估的努力，从而更好地支持妊娠预防。
