Stevens-Simon C, Kelly L, Singer D, Cox A
Department of Pediatrics, University of Colorado Health Science Center, Denver 80218, USA.
J Adolesc Health. 1996 Jul;19(1):48-53; discussion 54-5. doi: 10.1016/1054-139X(95)00281-V.
In this study we attempted to learn why childbearing adolescents failed to use contraceptives prior to conception. We hypothesized that among adolescents who elect to bear their children, positive and/or ambivalent feelings about having a baby are the most frequently cited reasons for not having used contraceptives.
This is a cross-sectional, clinic-based survey of a racially and ethnically diverse group of 200 consecutively enrolled, poor, pregnant, 13-18-year-old patients in an adolescent-oriented maternity program. The participants completed a self-administered questionnaire which elicited information about environmental and personal risk factors for inconsistent use of contraceptives and information about the reasons they had not used contraceptives consistently prior to conception. Student's t-tests, Chi-square, and logistic regression analyses were used.
The most frequently cited reasons for not using contraceptives prior to conception were: "I didn't mind getting pregnant" (20%) and "I wanted to get pregnant" (17.5%), followed by "I was using birth control but it didn't work (broke)" (12%), "I thought there was something wrong with me and I couldn't get pregnant" (9%) and "I just didn't get around to it" (9%). Teenagers who cited positive and/or ambivalent attitudes toward childbearing as their primary reason for not using contraceptives at the time of conception did not differ from others with regard to age, Medicaid status, gravidity, parity, frequency of living with parents, partner's age, depressive symptoms, or perceived family support. They were, however, more likely to have known the father of the baby for more than 6 months at the time of conception [odds ratio (OR) 2.53; 95% confidence interval (CI) 1.22-5.26) and to have dropped out of school (OR) 2.15; 95% CI 1.10-4.26].
The study hypothesis was supported. The absence of negative attitudes toward having babies rather than negative attitudes toward contraceptives is the most commonly cited reason for nonuse of contraceptives among childbearing adolescents. The results of this study may enable health care and social service providers to design more effective programs for preventing first and subsequent adolescent pregnancies.
在本研究中，我们试图了解生育期青少年在怀孕前未使用避孕药具的原因。我们假设，在选择生育孩子的青少年中，对生育持积极和/或矛盾情绪是未使用避孕药具的最常见原因。
这是一项基于诊所的横断面调查，对一个种族和民族多样化的群体进行了研究，该群体由200名连续登记的贫困、怀孕的13至18岁青少年患者组成，他们参与了一个面向青少年的产科项目。参与者完成了一份自我管理的问卷，该问卷收集了关于避孕药具使用不一致的环境和个人风险因素的信息，以及他们在怀孕前未持续使用避孕药具的原因的信息。使用了学生t检验、卡方检验和逻辑回归分析。
怀孕前未使用避孕药具的最常见原因是：“我不介意怀孕”（20%）和“我想怀孕”（17.5%），其次是“我在使用避孕措施，但它不起作用（破裂）”（12%）、“我认为自己有问题，无法怀孕”（9%）和“我只是没来得及做”（9%）。那些将对生育持积极和/或矛盾态度作为怀孕时未使用避孕药具的主要原因的青少年，在年龄、医疗补助状况、妊娠次数、产次、与父母同住的频率、伴侣年龄、抑郁症状或感知到的家庭支持方面与其他人没有差异。然而，他们在怀孕时认识孩子父亲超过6个月的可能性更大[优势比（OR）2.53；95%置信区间（CI）1.22 - 5.26]，并且辍学的可能性更大（OR）2.15；95% CI 1.10 - 4.26]。
研究假设得到支持。生育期青少年未使用避孕药具的最常见原因是对生育没有消极态度，而非对避孕药具持消极态度。本研究结果可能使医疗保健和社会服务提供者能够设计出更有效的项目来预防青少年首次及后续怀孕。
