Predicting pregnancy risk in women attending an STD clinic.
BACKGROUND
Although sexually transmitted disease (STD) clinics focus mainly on STD treatment and prevention, women attending these clinics are also at high risk for pregnancy.


OBJECTIVE
To evaluate the relationship between certain demographic and behavioral characteristics and the probability of pregnancy in women attending an urban STD clinic.


METHODS
Non-contraceptive-using women in an STD clinic-initiated randomized controlled contraception study (n = 877) were interviewed at baseline, and incident pregnancies within 1 year of enrollment were measured. Association between baseline demographic and behavioral characteristics with incident pregnancy was assessed by chi-square analysis, and logistic regression was used to assess factors associated with an incident pregnancy.


RESULTS
Among the 673 women (76.7%) for whom follow-up pregnancy information was available, 220 (32.7%) incident pregnancies occurred within 1 year. By logistic regression controlling for study assignment, incident pregnancy was associated with age < or =19 years (odds ratio [OR], 2.8; 95% CI: 1.5-5.2), previous abortion (OR, 3.1; 95% CI: 1.7-5.4), frequency of sexual encounters of at least once a week (OR, 1.8; 95% CI: 1.2-2.6), and having a chlamydial infection at the time of enrollment (OR, 1.8; 95% CI: 1.0-3.2). With a combination of demographic and behavioral characteristics correlated by univariate analysis with incident pregnancy (i.e., age < or =19 years, nonwhite race, high school/general equivalency diploma or less education, previous pregnancy, no use of birth control with last intercourse, sex at least once a week, previous abortion, > or =3 partners within the past month, and <17 years of age at first pregnancy), the cumulative risk of pregnancy with 6 or more of the 9 characteristics was 51%, compared with 25.6% for women with < or =5 characteristics.


CONCLUSIONS
For this STD clinic population, a combination of demographic and behavioral characteristics was useful when combined for identifying a subgroup of women at higher risk for subsequent pregnancy. Targeted intervention by STD care providers should include the provision for both pregnancy and STD prevention counseling.
Shlay
Judith C
JC
Departments of Public Health and Family Medicine, Denver Health and Hospital Authority, Denver, Colorado 80204-4507, USA. jshlay@DHHA.org
Mayhugh
Barbara
B
Foster
Mark
M
Maravi
Moises E
ME
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D003120:Colorado; D005260:Female; D005544:Forecasting; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011275:Pregnancy, Unwanted / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012309:Risk-Taking; D012731:Sex Counseling; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D014505:Urban Population