Assessing Pregnancy Intention and Associated Risks in Pregnant Adolescents
Abstract 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.
Assessing Pregnancy Intention and Associated Risks in Pregnant Adolescents
Abstract 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.
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