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Do Pregnant Teenagers Change Their Minds About The Reasons They Did Not Use Contraception?
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NASPAG 21st Annual Clinical Meeting
necessitating removal of the expander. One patient required a second operation to enhance breast symmetry. Of the 12 patients who had at least 4 weeks of followup after their completion of their reconstruction, 5 were subjectively documented as pleased with the result, 5 records made no mention of patient satisfaction, and 2 patients had concerns regarding their results. Conclusions: Our study shows promising results for the use of tissue expanders in young women with significant breast asymmetry or unilateral/bilateral micromastia. The complication rates of 6.7% for minor and 13.7 % for more major complications compare favorably to the literature on pediatric tissue expanders (19e38%). The only patient who necessitated early implant removal was a patient undergoing burn reconstruction who was also a smoker. When satisfaction was noted in the record, 5 patients were satisfied and two had some concern. The important issues of patient satisfaction and outcome need further study, before advocating an early surgical approach to adolescents with breast deformities. doi:10.1016/j.jpag.2007.03.074
Do Pregnant Teenagers Change Their Minds About The Reasons They Did Not Use Contraception? Jeanelle Sheeder, MSPH, Lisa Kelly, PA, and Catherine Stevens-Simon, MD University of Colorado Health Sciences Center, Department of Pediatrics, Denver, Colorado
Background: The reasons teens give for not using contraception prior to one pregnancy can inform the prevention of subsequent pregnancies. They are an attractive proxy for childbearing intentions because asking about contraceptive use eliminates the potentially stigmatizing experience of characterizing a pregnancy, and by extension a child, as unwanted. The purpose of this study was to determine if these explanations are sufficiently stable to be used as the basis for prevention intervention. Methods: The study enrolled a racially/ethnically diverse group of 1143, predominantly primiparous, 13 through 18 year old (mean sd: 16.9 1.3) pregnant, adolescent maternity program participants. At enrollment participants were asked to report why they had not used birth control at the time of conception by choosing all relevant explanations from a list of 30 common reasons for not using contraceptives. Blank spaces are provided for additional reasons.
Those who enrolled prior to the 28th week of gestation (n 5 791) were asked to complete the questionnaire again between 28 and 32 weeks gestation. Responses were systematically sorted into the 6 categories given in the table. Stability was assessed using the Kappa statistic. The analysis controlled for age, race/ethnicity, gravidity and parity, living arrangement, education level and participation, future family and career plans, relationship with the baby’s father and maternal grandmother and other boyfriends, and gestational week. Results: On average participants completed the first questionnaire (Q1) at 18.7 9.5 weeks (range 2.4 to 40.0 weeks) and the second questionnaire (Q2) at 34.1 2.9 weeks (range 25.4 to 40.1 weeks). The most common reasons given on Q1 were ‘‘not ready to try to prevent pregnancy’’ (38.4%) and not ready to think about pregnancy prevention (19.1%). The frequency with which participants who completed two questionnaires endorsed each response on Q1 and Q2 and the correspondence between them is given in the Table. Overall agreement between Q1and Q2 was fair. Not being prepared to prevent pregnancy was the only reason that achieved a good level of agreement. Of those who endorsed this response on Q1, 70% did on Q2; 30% of those who did not endorse this response on Q1 did on Q2. The effects of the control variables on this transition will be discussed. Conclusions: The reasons teens give for not using contraception prior to conception identify treatable causes of unintended conception, the majority of which are sufficiently stable to be used in designing interventions to prevent subsequent unwanted pregnancies. Contrary to expectation, the teens did not become more likely to attribute their failure to use contraception to their lack of motivation to delay pregnancy as gestation progressed. doi:10.1016/j.jpag.2007.03.075
Preliminary Data From a Randomized Clinical Trial of Bone Mineral Density in Adolescent Girls Using Oral Contraceptives Containing Different Levels of Estrogen Barbara Cromer, MD, Kelly Camlin-Shingler, LISW, and Michelle Secic, MS MetroHealth Medical Center, Cleveland, Ohio; Transitional Living Services, Albuquerque, New Mexico; Secic Statistical Consulting, Inc, Chardon, Ohio
NASPAG 21st Annual Clinical Meeting
necessitating removal of the expander. One patient required a second operation to enhance breast symmetry. Of the 12 patients who had at least 4 weeks of followup after their completion of their reconstruction, 5 were subjectively documented as pleased with the result, 5 records made no mention of patient satisfaction, and 2 patients had concerns regarding their results. Conclusions: Our study shows promising results for the use of tissue expanders in young women with significant breast asymmetry or unilateral/bilateral micromastia. The complication rates of 6.7% for minor and 13.7 % for more major complications compare favorably to the literature on pediatric tissue expanders (19e38%). The only patient who necessitated early implant removal was a patient undergoing burn reconstruction who was also a smoker. When satisfaction was noted in the record, 5 patients were satisfied and two had some concern. The important issues of patient satisfaction and outcome need further study, before advocating an early surgical approach to adolescents with breast deformities. doi:10.1016/j.jpag.2007.03.074
Do Pregnant Teenagers Change Their Minds About The Reasons They Did Not Use Contraception? Jeanelle Sheeder, MSPH, Lisa Kelly, PA, and Catherine Stevens-Simon, MD University of Colorado Health Sciences Center, Department of Pediatrics, Denver, Colorado
Background: The reasons teens give for not using contraception prior to one pregnancy can inform the prevention of subsequent pregnancies. They are an attractive proxy for childbearing intentions because asking about contraceptive use eliminates the potentially stigmatizing experience of characterizing a pregnancy, and by extension a child, as unwanted. The purpose of this study was to determine if these explanations are sufficiently stable to be used as the basis for prevention intervention. Methods: The study enrolled a racially/ethnically diverse group of 1143, predominantly primiparous, 13 through 18 year old (mean sd: 16.9 1.3) pregnant, adolescent maternity program participants. At enrollment participants were asked to report why they had not used birth control at the time of conception by choosing all relevant explanations from a list of 30 common reasons for not using contraceptives. Blank spaces are provided for additional reasons.
Those who enrolled prior to the 28th week of gestation (n 5 791) were asked to complete the questionnaire again between 28 and 32 weeks gestation. Responses were systematically sorted into the 6 categories given in the table. Stability was assessed using the Kappa statistic. The analysis controlled for age, race/ethnicity, gravidity and parity, living arrangement, education level and participation, future family and career plans, relationship with the baby’s father and maternal grandmother and other boyfriends, and gestational week. Results: On average participants completed the first questionnaire (Q1) at 18.7 9.5 weeks (range 2.4 to 40.0 weeks) and the second questionnaire (Q2) at 34.1 2.9 weeks (range 25.4 to 40.1 weeks). The most common reasons given on Q1 were ‘‘not ready to try to prevent pregnancy’’ (38.4%) and not ready to think about pregnancy prevention (19.1%). The frequency with which participants who completed two questionnaires endorsed each response on Q1 and Q2 and the correspondence between them is given in the Table. Overall agreement between Q1and Q2 was fair. Not being prepared to prevent pregnancy was the only reason that achieved a good level of agreement. Of those who endorsed this response on Q1, 70% did on Q2; 30% of those who did not endorse this response on Q1 did on Q2. The effects of the control variables on this transition will be discussed. Conclusions: The reasons teens give for not using contraception prior to conception identify treatable causes of unintended conception, the majority of which are sufficiently stable to be used in designing interventions to prevent subsequent unwanted pregnancies. Contrary to expectation, the teens did not become more likely to attribute their failure to use contraception to their lack of motivation to delay pregnancy as gestation progressed. doi:10.1016/j.jpag.2007.03.075
Preliminary Data From a Randomized Clinical Trial of Bone Mineral Density in Adolescent Girls Using Oral Contraceptives Containing Different Levels of Estrogen Barbara Cromer, MD, Kelly Camlin-Shingler, LISW, and Michelle Secic, MS MetroHealth Medical Center, Cleveland, Ohio; Transitional Living Services, Albuquerque, New Mexico; Secic Statistical Consulting, Inc, Chardon, Ohio