Adolescent pregnancy desire and pregnancy incidence

Research has suggested the importance of pregnancy desire in explaining pregnancy risk behavior among adolescent females. Much of the literature, however, uses cross-sectional study designs to examine this relationship. Because bias may strongly influence these results, more prospective studies are needed to confirm the relationship between pregnancy desire and pregnancy incidence over time.

Nonpregnant adolescents aged 14- to 19 years (n = 208) completed baseline interviews and interviews every 6 months thereafter for 18 months. Logistic regression was used to examine demographic and psychosocial correlates of pregnancy desire. Cox regression analysis was used to determine whether pregnancy desire predicted pregnancy incidence over time after controlling for potential confounders.

Twenty-four percent of participants either desired pregnancy or were ambivalent toward pregnancy in the next year. Pregnancy desire was associated with older age, relationship duration of <6 months, and greater perceived stress. After accounting for potential confounders, pregnancy desire doubled the risk of becoming pregnant over the 18-month follow-up period (relative risk, 2.00; 95% confidence interval [CI], 0.99-4.02). Additionally, a heightened risk for pregnancy was found among those who expressed some desire for pregnancy and who were not in school compared with those who expressed no desire for pregnancy and who were in school (relative risk, 4.84; 95% CI, 1.21-19.31).

Our analysis reinforces the importance of evaluating pregnancy desire among sexually active adolescent females. Interventions should target young women in new romantic relationships and who are not in school to improve pregnancy prevention efforts. Additionally, improving coping abilities may help to reduce feelings of pregnancy desire among adolescent females.