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Reliability of adolescent pre-pregnancy weight history in different ethnic groups
CARE Vd. 9, No. 3
JOURNAL OF ADOLESCENT HE
RglRO$PECTIVE IDWTIFICATION OF TSE SASILT DEVELOPING MALE. Martin I& ~eraon, M.D.. Div. Jf Adol. Hod., N.Y. Med. ColleBe
Valhalla, N.Y., Susan Willetein. PhD, Charles E. Irwin, M.D.. 6 Charles Wibble-. W.D., Div. of Mol. kd., U.C. San
gllen
Abdallan. t8.B.. aud Ulo Rosenuinlwl.
Uniwx~it~of
B.S.
t4lnnemte llo~pital,tinnespolis. Wt7. Thin sttiy wss undsrtsksn to erplora association0 between Chlaaydia trrchmativ (C. trach.) mdoctrvieal infections and cUaioa1 dstc obtained Eras adolescents’ sediesl hietory and physical sxadlatlon. ISa prospectively atudkd LB2conaecutlw wumen(94%White, 3L BlEck), 21 years
of age 01 less (m8an. 18 yeara). needing plvic exbmin4tlonD in ea adolescent clinic. ReasouM for BXI included initial family planning (29%). routina annual visit (SW, qunpectod pregnancy (22Z), wwally tranrolttod disease (20X). and ml~eallanaaus others. lka~acimeed clinicians obtained and recorUti d&t; ragardinf# daWwaphica, rmuai history, phyalcal EndocervIcal acar~ yen *brained frcr all wbjcta for signa and syaptwe. c. trcCh. diagmvla by the fluoro@ctln-conjugated mnoclonlc antibody (PA) dir~peciaen Ce(tt (rlrmTrak; Syva, Co). Clinicians wm blind to FA rsaults. Data fm (infactcdl subfacts nn compnred td FA-
FAt
io rnnble
LIDio identify
ihs
surly
developing
(non-infected) controls. uslna X2and E teata. Thirty aubjecta (15X) =rm PAt;2.41 of gonorrhea colrucen ware positive; and 4.3X of rrat prep8 revralsd Trichoaone8 v@nalPs. Caapared to controls, PA+ rubjscte ware found to have mote (ti.05) aexuel partner0 in thnpmet year(mean. 3 v. 21, complmintm of nvtrorrhagia (2DXv. 7X). abnormal vutnal dlscharaa an ~u~am (37X v. 221). PUS from the cnwicrl oe (17X v. YXJ, axocerv¶cl~i~ (POXP. 16X), and p&irlvs gonorrhea cwlturoo (7X v. 1X). Sy dlsicrlalnant dysia, metrottkagla and exocarvicitls wn the only inporellnt varlabler diatinguinhing mubjacte from controls. mS pra~anes of aithet flndin# carmctly LdantifW $61 of FAt aubjacta a~ infected. The abeonce of althor flnding correctly clsanified 82%of PA- contrOla ab not rlgnificmt sssoclationa infected. Weconclude that there on statioticslly In rimllar brtwaQnaelect clinical abnomalltlea and & trach. infactioas. popularlone, tha abaencs of exocrrvreit~s and~oerk~U may bu particularly kelpPu1 in iduntifylg poroan# at low ti#k Par Snfectlan.
male.
19 RgfXAT PRXGWAWCY TN ADGLESCXWTS A “PLANNED”AFFAlR? Yuko Fe1ice.M.D.. Shrana. H.A.. Dorothy R; AollinRmmrth, M.D;-iMport&nts of Pediatrics. Clinical im~oareh Cantor b Reproduetivo Nedicine. University of California SanlDlsgo School of Medicine and Medical Center, San
t4arianno 15.
Wltmhasi. M.D..G.Wul
Dir&a, CA, In order to better plan a repent pfepancy prevention progrnm, we InveEtlgated thn rearonn for brcoming praguant oxpren6Cd by grwid who rrpirtnrrd for prmstel cam Uaiveraity Teen OB Clinic between May 1984 The putpole of this study VP@ determine whether girls who and July 1987. bccm pregnant for the aacond tima or 11ore do PQ for different reasona than girls who am pregnant for the first time. Onehundred and fifty pregnant sdoleacanto (G 16.04 yra. i 1.3 ) were intsrvinrad at their firer prenatal viait and divided into 2 groups by prrity. Thor@ in Group 1 03) were pregnant for the firet fnw104. 693X) and there in Group 2 (62) vere pregnant for the 6ccend time or more In=46. 30.62). Gompariuon data were nubjoctcd to t-teat and chi aquora annlyaoo. The racial eou@osltion of both group8 varo eimilar (41X Black. 29X Hispanic. 23% White. a& 7% other). The girls in C2 ware sli htly older (; 16.7 yrs. 21.2) than the in Cl Ix‘ 15.7 yra. 31.3; p & ODOl). but thurr was no difference batvuen &roupe in mmital atatun (11X Cl marrind, 15XC2; p NS). 60%of the Rirln in 02 hod living childran horn+ but they ware mom likaly than thoas 4 fil to ItaCo that they bacti pregnant bwausp they wanted o baby (02 44%.
at a
teen-agero
to
time
girla
at
About
Cl 21X: ~~~011 and conver~e1~. air18 In Cl w@romore likolv thnn those in 02 to ataie-that ihr pr’(I&w%wy &I; &I acc.Ldmt and just hnpponid (01 61X, 0237X; pQ.01). Girla in 02 ptsuentcd Par prtanatnl cat@ at an w.rlier gantationut rge then than@ in Gl (02 17.1 rrlr0.r 8.91 Gl 20.4 wka. t 8.5: p(0.W). Conclusions AdoSescmt pregnancy provantion programs glut nut pre~ulns that malt school-age prDRnuncla84~ accidental, since manygirls who beeccaeprugnnnt mum than onne rppaar to be doing uo intentionally.
AmLTUDgSAND ISLISPS TWAPDS SRBASTFSSDING AND FACT%3 AFPgGTISG THBHGTUBR’S CRGICgOF INPMT PPLDINGHETHOD WJFC @RtiONANTADDLKSCgKpS. Wry Story, Ph.D., R.D. and Llnds J. .jlnrrLo, I(&. Adoleacant Realth Progc=, Univ. of nInnasota, #lnn*apolie, Hlnnancta. st\ldy 1avcatLgated atticudee and belielo abut breaatfetding and
thla factata affsctinp the teenage wther’r choice of infant frcdinu aathod. 2111 pregnant adokcente (&I9 yru.) *era igiven a questionnaire-during a pranwal clinic Half ampla planned on braaatfeedlng; 41X lntandad on bottl~fesding. and BX oars undecided. No ~igniflcant dlffsaner8 !mre found between breratfeadara and bottlefeeders for uternal age; educational level; or mrital atawe. Ethnlclty UOB found to be li@fieant tith 71.7% of LIlapanics intending to breaetfmd compared to S?.4%of Uhltan and 37.5X of Slacks. Postpartum plans to return rchool Yu *tatad u a War rt8eon far not breaatftsding by 62.1% of the edolrrcmta. Half of the boyfritndalhusband~ had mprmacd a praferanee for infant fernCti~~ rsthod and, of those, 67.9X favorci brarstfaading. For there mothare to b?ea.atPeed. hsload in
virtt.
the
to
tatendlne
th%aanaathat moat
t&lnR the dacirlon wai either thr @~l’s m&her or the baby’6 iather. ~~~~~~ tended CO consult althar thalr mothor QC m&e the decision . I(rtarnal attltudel and beliefa tovrrdu brsaotfaadiq were lignificsatly diffarant betwrsn the twogroups. Tamrgere planning to bnutfwd were 10r1 convinced that brea.vtfacding w.aa best for the baby’s h&h. we wre natural. rara nutrltlwtr. and oroaoted cloraneos . betlrf&ors *RIO mom likely to believe -the br&stfteding wae .too difficult, tieu dam the mother, and too tine conmming. Boctlcheders rlao tended to faal that they dld not eat s@ll tnnugl~ to breastfeed and rntrv too nerw&!.. Il~lhcp rem more likelyta disapprove of wmm breastfeeding tn public and more mbartassed to brvaatfevd in front of others. Of the total aepla. 39X said they did mot know uch about breastfeeding (48.11 of thebottlefeedars vs. 32.2X of thebreastfeeders). 60.4% of the Oatimm~plcexprce8e4 a daoire to Law more about breastfeeding (44.92 oL thm bottlaftiera n. 73.52 of thebreuthedtrs).
RELIABILXTY OF ADGLISCBWT PRR-PRKWANCT WEIGHT HISTORT IN DIFPEWNf ETHNTC EROUFS. Uali Buhlmann.l4.D.. Pam&s P. Tom. M.D., klnrianne E. Felice, M.D., C. Pmul Shragg. #.A., Dorothy R. Hollingavorth, M.D. Department6 of Pediatricor Clinics1 ReeanrchCantal 6 Reproductive Madicim, University of California San Diego School of Hedielna and Wadicsl Centtr,San Diego, CA Low prc-pteBnancy weight (PP wt.). or inadequate vcight gain during pregnancy. incrtasee the rink for poor fetal outcome. An acwrttte PP wt. ia important to identify this high-risk group. One proviourr utudy indicate6 that PF wt. histories in Black prevnt adolescsnts i~rs usually accurate in noCWl Wi8ht taBnn. The purpose of this otudy VBBto datemine the accuracy of PP wt. obtained by historyfrcn rdolaacente from different ethnic backgruunds, l%s study population coneieted of BDpregnant adolrecmte (zrge‘17.5 ym. + 1.37 yro.) followed in a Univoraity Tm OBClioic for prenatal care, including 31 Caucasians. 27 Blacks. and 22 Kaxican-Americanu. PP wto. were
at
Lirst
requeatad ths prenatal vieit (nean gestational age lg.5 Ulna. f 8.68 uks.1 and were varified either through hospital chart6 or rsco?da of other clinics or private doctore. Patients wore includsd only if the verified weight UBBrecorded within 12 moathe of concaption. The.regreaaioo &wlysia rssults shoved a overall correlation (r-D.91; p(O.GGl betweeo PP wt. by
written
high
hirrtory end verified weigkts before conception. There wre 110 statistically significant differences betwsen the three ethnic groupe: Caucneiano rM3.89; Ksxican-Americansr-0.96; Blacks r-0.89. lhurr thin tcudy confiraa previously reported dntm in a predorainnntly black population and indicatea that pre-pregnancy weight8 by hiatory in Csucaaian t4exican-American, and Black adolescents are accurate andmay be used to identify high rink groups of school-agsd mother&
TUINGS TRATWORRY HE- A PRELIHIM’.REPORT.Robert T. Brwn. M.D., Patricia B. Hendemon. A.P J.W.. Mary C. Revolinaky. B.A.. gslth
Knufmen.
Ph.D,.
Dennis
Smrth.
Ph.D.
Dsot.
of Pediatrics.
Ohio State Univ., Cbildren’e Rospitel. Columb~. Ohio. Much has been written about adolescents’ health problems and health concerns, but little date exist on adoltecsnt worriee. “‘Ihinge That WorryHe,” a quentionnrire with 87 check-off itemu wan administered to new patientr in n general adolerctnt aadicmne clinic. Preliminary rteulte tram au analvaie of the ton5 worries of each of 466 sdoleacenrs were tabulated. 23X of &spundents l&d ‘)ly Weight” BB o major concern (B6 of 296.girls. 292, 20 of 168 boye, 12X). “Getting Bad Grades” and “Tests at School” were listed by 18X and 13% of the boye and by 13X and 12X of the girls respectively. ‘worry About pregnancy” concerned 15%of the girls. but only 5X of the boys. 13X of the boys and 9X of the girlt listed “Ueath in the Family” 88 a top 5 worry. 13%of the boye listed “Not Having EnoughMoney”as a major concern. while this concerned only 3%of the girls. “Uar/Wucleer War” was a major worry of 11X of the boys, but of only 51 of the girls. Black (n-207) and white (n-246) adolescents had very similar concerns. “Beina MadeFun Of” worried worried
1DX of teens
414 y/o
but
only
2X of older
teens.
while
14X of 15-16 ;/a bova but onlv 1X of those 44 v/o. In addition to the’&&1 utilit; of this info&&n in
“Getting
Hurt”
preventive
end therapeutic counselling of sn sdolsscent. these and further analyses of adolescent worries should enable health orofessionals to tailor educational programs and health intervsntions to mo6 specifically the perceived needs of their clienta.
meet
JOURNAL OF ADOLESCENT HE
RglRO$PECTIVE IDWTIFICATION OF TSE SASILT DEVELOPING MALE. Martin I& ~eraon, M.D.. Div. Jf Adol. Hod., N.Y. Med. ColleBe
Valhalla, N.Y., Susan Willetein. PhD, Charles E. Irwin, M.D.. 6 Charles Wibble-. W.D., Div. of Mol. kd., U.C. San
gllen
Abdallan. t8.B.. aud Ulo Rosenuinlwl.
Uniwx~it~of
B.S.
t4lnnemte llo~pital,tinnespolis. Wt7. Thin sttiy wss undsrtsksn to erplora association0 between Chlaaydia trrchmativ (C. trach.) mdoctrvieal infections and cUaioa1 dstc obtained Eras adolescents’ sediesl hietory and physical sxadlatlon. ISa prospectively atudkd LB2conaecutlw wumen(94%White, 3L BlEck), 21 years
of age 01 less (m8an. 18 yeara). needing plvic exbmin4tlonD in ea adolescent clinic. ReasouM for BXI included initial family planning (29%). routina annual visit (SW, qunpectod pregnancy (22Z), wwally tranrolttod disease (20X). and ml~eallanaaus others. lka~acimeed clinicians obtained and recorUti d&t; ragardinf# daWwaphica, rmuai history, phyalcal EndocervIcal acar~ yen *brained frcr all wbjcta for signa and syaptwe. c. trcCh. diagmvla by the fluoro@ctln-conjugated mnoclonlc antibody (PA) dir~peciaen Ce(tt (rlrmTrak; Syva, Co). Clinicians wm blind to FA rsaults. Data fm (infactcdl subfacts nn compnred td FA-
FAt
io rnnble
LIDio identify
ihs
surly
developing
(non-infected) controls. uslna X2and E teata. Thirty aubjecta (15X) =rm PAt;2.41 of gonorrhea colrucen ware positive; and 4.3X of rrat prep8 revralsd Trichoaone8 v@nalPs. Caapared to controls, PA+ rubjscte ware found to have mote (ti.05) aexuel partner0 in thnpmet year(mean. 3 v. 21, complmintm of nvtrorrhagia (2DXv. 7X). abnormal vutnal dlscharaa an ~u~am (37X v. 221). PUS from the cnwicrl oe (17X v. YXJ, axocerv¶cl~i~ (POXP. 16X), and p&irlvs gonorrhea cwlturoo (7X v. 1X). Sy dlsicrlalnant dysia, metrottkagla and exocarvicitls wn the only inporellnt varlabler diatinguinhing mubjacte from controls. mS pra~anes of aithet flndin# carmctly LdantifW $61 of FAt aubjacta a~ infected. The abeonce of althor flnding correctly clsanified 82%of PA- contrOla ab not rlgnificmt sssoclationa infected. Weconclude that there on statioticslly In rimllar brtwaQnaelect clinical abnomalltlea and & trach. infactioas. popularlone, tha abaencs of exocrrvreit~s and~oerk~U may bu particularly kelpPu1 in iduntifylg poroan# at low ti#k Par Snfectlan.
male.
19 RgfXAT PRXGWAWCY TN ADGLESCXWTS A “PLANNED”AFFAlR? Yuko Fe1ice.M.D.. Shrana. H.A.. Dorothy R; AollinRmmrth, M.D;-iMport&nts of Pediatrics. Clinical im~oareh Cantor b Reproduetivo Nedicine. University of California SanlDlsgo School of Medicine and Medical Center, San
t4arianno 15.
Wltmhasi. M.D..G.Wul
Dir&a, CA, In order to better plan a repent pfepancy prevention progrnm, we InveEtlgated thn rearonn for brcoming praguant oxpren6Cd by grwid who rrpirtnrrd for prmstel cam Uaiveraity Teen OB Clinic between May 1984 The putpole of this study VP@ determine whether girls who and July 1987. bccm pregnant for the aacond tima or 11ore do PQ for different reasona than girls who am pregnant for the first time. Onehundred and fifty pregnant sdoleacanto (G 16.04 yra. i 1.3 ) were intsrvinrad at their firer prenatal viait and divided into 2 groups by prrity. Thor@ in Group 1 03) were pregnant for the firet fnw104. 693X) and there in Group 2 (62) vere pregnant for the 6ccend time or more In=46. 30.62). Gompariuon data were nubjoctcd to t-teat and chi aquora annlyaoo. The racial eou@osltion of both group8 varo eimilar (41X Black. 29X Hispanic. 23% White. a& 7% other). The girls in C2 ware sli htly older (; 16.7 yrs. 21.2) than the in Cl Ix‘ 15.7 yra. 31.3; p & ODOl). but thurr was no difference batvuen &roupe in mmital atatun (11X Cl marrind, 15XC2; p NS). 60%of the Rirln in 02 hod living childran horn+ but they ware mom likaly than thoas 4 fil to ItaCo that they bacti pregnant bwausp they wanted o baby (02 44%.
at a
teen-agero
to
time
girla
at
About
Cl 21X: ~~~011 and conver~e1~. air18 In Cl w@romore likolv thnn those in 02 to ataie-that ihr pr’(I&w%wy &I; &I acc.Ldmt and just hnpponid (01 61X, 0237X; pQ.01). Girla in 02 ptsuentcd Par prtanatnl cat@ at an w.rlier gantationut rge then than@ in Gl (02 17.1 rrlr0.r 8.91 Gl 20.4 wka. t 8.5: p(0.W). Conclusions AdoSescmt pregnancy provantion programs glut nut pre~ulns that malt school-age prDRnuncla84~ accidental, since manygirls who beeccaeprugnnnt mum than onne rppaar to be doing uo intentionally.
AmLTUDgSAND ISLISPS TWAPDS SRBASTFSSDING AND FACT%3 AFPgGTISG THBHGTUBR’S CRGICgOF INPMT PPLDINGHETHOD WJFC @RtiONANTADDLKSCgKpS. Wry Story, Ph.D., R.D. and Llnds J. .jlnrrLo, I(&. Adoleacant Realth Progc=, Univ. of nInnasota, #lnn*apolie, Hlnnancta. st\ldy 1avcatLgated atticudee and belielo abut breaatfetding and
thla factata affsctinp the teenage wther’r choice of infant frcdinu aathod. 2111 pregnant adokcente (&I9 yru.) *era igiven a questionnaire-during a pranwal clinic Half ampla planned on braaatfeedlng; 41X lntandad on bottl~fesding. and BX oars undecided. No ~igniflcant dlffsaner8 !mre found between breratfeadara and bottlefeeders for uternal age; educational level; or mrital atawe. Ethnlclty UOB found to be li@fieant tith 71.7% of LIlapanics intending to breaetfmd compared to S?.4%of Uhltan and 37.5X of Slacks. Postpartum plans to return rchool Yu *tatad u a War rt8eon far not breaatftsding by 62.1% of the edolrrcmta. Half of the boyfritndalhusband~ had mprmacd a praferanee for infant fernCti~~ rsthod and, of those, 67.9X favorci brarstfaading. For there mothare to b?ea.atPeed. hsload in
virtt.
the
to
tatendlne
th%aanaathat moat
t&lnR the dacirlon wai either thr @~l’s m&her or the baby’6 iather. ~~~~~~ tended CO consult althar thalr mothor QC m&e the decision . I(rtarnal attltudel and beliefa tovrrdu brsaotfaadiq were lignificsatly diffarant betwrsn the twogroups. Tamrgere planning to bnutfwd were 10r1 convinced that brea.vtfacding w.aa best for the baby’s h&h. we wre natural. rara nutrltlwtr. and oroaoted cloraneos . betlrf&ors *RIO mom likely to believe -the br&stfteding wae .too difficult, tieu dam the mother, and too tine conmming. Boctlcheders rlao tended to faal that they dld not eat s@ll tnnugl~ to breastfeed and rntrv too nerw&!.. Il~lhcp rem more likelyta disapprove of wmm breastfeeding tn public and more mbartassed to brvaatfevd in front of others. Of the total aepla. 39X said they did mot know uch about breastfeeding (48.11 of thebottlefeedars vs. 32.2X of thebreastfeeders). 60.4% of the Oatimm~plcexprce8e4 a daoire to Law more about breastfeeding (44.92 oL thm bottlaftiera n. 73.52 of thebreuthedtrs).
RELIABILXTY OF ADGLISCBWT PRR-PRKWANCT WEIGHT HISTORT IN DIFPEWNf ETHNTC EROUFS. Uali Buhlmann.l4.D.. Pam&s P. Tom. M.D., klnrianne E. Felice, M.D., C. Pmul Shragg. #.A., Dorothy R. Hollingavorth, M.D. Department6 of Pediatricor Clinics1 ReeanrchCantal 6 Reproductive Madicim, University of California San Diego School of Hedielna and Wadicsl Centtr,San Diego, CA Low prc-pteBnancy weight (PP wt.). or inadequate vcight gain during pregnancy. incrtasee the rink for poor fetal outcome. An acwrttte PP wt. ia important to identify this high-risk group. One proviourr utudy indicate6 that PF wt. histories in Black prevnt adolescsnts i~rs usually accurate in noCWl Wi8ht taBnn. The purpose of this otudy VBBto datemine the accuracy of PP wt. obtained by historyfrcn rdolaacente from different ethnic backgruunds, l%s study population coneieted of BDpregnant adolrecmte (zrge‘17.5 ym. + 1.37 yro.) followed in a Univoraity Tm OBClioic for prenatal care, including 31 Caucasians. 27 Blacks. and 22 Kaxican-Americanu. PP wto. were
at
Lirst
requeatad ths prenatal vieit (nean gestational age lg.5 Ulna. f 8.68 uks.1 and were varified either through hospital chart6 or rsco?da of other clinics or private doctore. Patients wore includsd only if the verified weight UBBrecorded within 12 moathe of concaption. The.regreaaioo &wlysia rssults shoved a overall correlation (r-D.91; p(O.GGl betweeo PP wt. by
written
high
hirrtory end verified weigkts before conception. There wre 110 statistically significant differences betwsen the three ethnic groupe: Caucneiano rM3.89; Ksxican-Americansr-0.96; Blacks r-0.89. lhurr thin tcudy confiraa previously reported dntm in a predorainnntly black population and indicatea that pre-pregnancy weight8 by hiatory in Csucaaian t4exican-American, and Black adolescents are accurate andmay be used to identify high rink groups of school-agsd mother&
TUINGS TRATWORRY HE- A PRELIHIM’.REPORT.Robert T. Brwn. M.D., Patricia B. Hendemon. A.P J.W.. Mary C. Revolinaky. B.A.. gslth
Knufmen.
Ph.D,.
Dennis
Smrth.
Ph.D.
Dsot.
of Pediatrics.
Ohio State Univ., Cbildren’e Rospitel. Columb~. Ohio. Much has been written about adolescents’ health problems and health concerns, but little date exist on adoltecsnt worriee. “‘Ihinge That WorryHe,” a quentionnrire with 87 check-off itemu wan administered to new patientr in n general adolerctnt aadicmne clinic. Preliminary rteulte tram au analvaie of the ton5 worries of each of 466 sdoleacenrs were tabulated. 23X of &spundents l&d ‘)ly Weight” BB o major concern (B6 of 296.girls. 292, 20 of 168 boye, 12X). “Getting Bad Grades” and “Tests at School” were listed by 18X and 13% of the boye and by 13X and 12X of the girls respectively. ‘worry About pregnancy” concerned 15%of the girls. but only 5X of the boys. 13X of the boys and 9X of the girlt listed “Ueath in the Family” 88 a top 5 worry. 13%of the boye listed “Not Having EnoughMoney”as a major concern. while this concerned only 3%of the girls. “Uar/Wucleer War” was a major worry of 11X of the boys, but of only 51 of the girls. Black (n-207) and white (n-246) adolescents had very similar concerns. “Beina MadeFun Of” worried worried
1DX of teens
414 y/o
but
only
2X of older
teens.
while
14X of 15-16 ;/a bova but onlv 1X of those 44 v/o. In addition to the’&&1 utilit; of this info&&n in
“Getting
Hurt”
preventive
end therapeutic counselling of sn sdolsscent. these and further analyses of adolescent worries should enable health orofessionals to tailor educational programs and health intervsntions to mo6 specifically the perceived needs of their clienta.
meet