RESUMO
This prospective study investigated predictors of repeat pregnancies by 12 months after the delivery of a first child and their outcomes in inner-city adolescent mothers. The sample included four groups: those who had therapeutic abortions, miscarriages, full-term deliveries, and no repeat pregnancy. The therapeutic abortion group had more pregnancies before their first delivery (41%) than did full term (20%) and no repeat (15%), p less than .01. More delayed grade placement was found in therapeutic abortion -1.6 years (1.3) and full term -1.8 years (.9) than in no repeat pregnancy -.6 years (1.1), p less .001. Reading achievement scores were higher in no repeat 86.3 (17.1) than in full term 75.0 (16.5), p less than .05. School attendance was higher in no repeat (65%) than in therapeutic abortion (35%) and full-term (24%) p less than .01 groups. Depressive symptoms at baseline were higher among therapeutic aborters 18.9 (9.9) than among full term 10.2 (8.2) and no repeat pregnancy groups 12.2 (6.2). Logistic regression analyses identified delayed grade placement as the most important predictor of pregnancy outcome.
PIP: The purpose of this prospective study of 120 black and Puerto Rican adolescent mothers recruited from an urban adolescent health center was 1) to identify multiple predictors of repeat pregnancies and their outcomes, and 2) to assess the relative contribution of these predictors to repeat pregnancies. Variables include demographic factors, frequency of sexual activity, contraceptive method used, occurrence of pregnancies before the first delivery, educational attainment, and levels of depressive symptoms by 3 weeks postpartum. Pregnancy outcomes included mothers who terminated their pregnancy, who delivered a live birth, and who had a miscarriage; data were available 12 months postpartum. The mean age was 17.13 years. 52% were black and 44% were Puerto Rican and of low socioeconomic status. Reliability of self-reports was 95%. 60.3% had no repeat pregnancy and 39.6% became pregnant during the 1-year followup, of which 15.3% had a therapeutic abortion, 6.3% miscarried, and 18.1% carried to term. There were no significant differences in the characteristics of the repeat and nonrepeat pregnancy groups. The procedure involved interviews at 2-4 weeks (time 1), 6-7 months (time 2), and 12-13 months (time 3). Measures for delayed grade placement, reading achievement, career aspirations and socioeconomic status of the family, and school attendance are described. Multivariate analysis, univariate analyses, and Duncan multiple range tests were conducted as well as logistic regression model construction. The significant predictors of pregnancy outcome (repeat pregnancy) were having 2 or more previous pregnancies. The abortion group was twice as likely to have had a pregnancy before the birth of the first child (41%) than the full-term (20%) and the no-repeat groups (15%). There were no differences in frequency of sexual activity or contraceptive method used. In the no-repeat and miscarriage groups, grade placement was less delayed. In the no-repeat group, reading achievement scores were higher than in the full-term group. There were no differences in career aspirations. 65% of the no-repeat group were attending school at time 2 while only 35% of the therapeutic and 24% of the full-term groups were attending school. Depressive scores were significantly higher for the abortion group. Delayed grade placement was the only predictor independently associated with the increased log odds of repeat pregnancy.
Assuntos
Negro ou Afro-Americano/psicologia , Hispânico ou Latino/psicologia , Resultado da Gravidez/psicologia , Gravidez na Adolescência/psicologia , Logro , Adolescente , Aspirações Psicológicas , Depressão/psicologia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Gravidez , Gravidez na Adolescência/etnologia , Estudos Prospectivos , Porto Rico/etnologia , Recidiva , Análise de RegressãoRESUMO
PIP: Adolescent minority group females experience of anal intercourse and knowledge about and attitudes toward AIDS have been investigated. A questionnaire survey was administered to 148 largely black and Hispanic female patients at an adolescent health center. 111 of the girls reported that they were sexually active. 28 girls (25.2%) acknowledged having had anal sex, 19 of them within the preceding 3 months. Condoms were far less likely to be used during anal intercourse than during vaginal sex. Accurate knowledge about AIDS increased with age, but there was no relationship between age and any change in sexual behavior to avoid the disease. What little changes in sexual behavior reported were, however, strongly linked to fear of contracting AIDS. The most effective means of HIV transmission from males to females is through anal intercourse. Given the high incidence of anal intercourse practice by black and Hispanic females, their infrequent use of condoms during anal intercourse, and a large and increasing HIV infection rate among black and Hispanic males, it can be seen that adolescent minority group females are at increasing risk of heterosexual exposure to HIV infection. Lack of relationship between knowledge about AIDS and reduction of high-risk sexual behavior are discouraging to hopes of disease prevention through educational efforts.^ieng