Psychosocial predictors of pregnancy among low-income African-American adolescent females: a prospective analysis.
OBJECTIVE
To prospectively identify psychosocial predictors of pregnancy among African-American adolescent females.


METHODS
African-American females, 14-18 yrs old, were recruited from schools and health clinics in low-income neighborhoods. Adolescents completed an in-depth survey and provided urine specimens for pregnancy testing at baseline and 6-month intervals for 1.5 years. Selected problem behaviors, demographic, and psychosocial variables were tested for bivariate and multivariate significance relative to biologically confirmed pregnancy during the follow-up period. Only adolescents who initially tested negative for pregnancy were included (n = 241).


RESULTS
About 26% (n = 63) of the adolescents became pregnant over the follow-up period. Although a broad spectrum of variables achieved bivariate significance, few retained significance in the multivariate model. Multivariate predictors of pregnancy were biologically confirmed marijuana use (adjusted odds ratios [AOR] = 12.4, P = 0.0003) and perceiving that the sex partner desired pregnancy (AOR = 1.27, P = 0.01). A protective effect was observed for adolescents who reported that a family member received welfare benefits; these adolescents were about 60% less likely to become pregnant (AOR = 0.38, P = 0.04).


CONCLUSIONS
Pediatricians and other health professionals who participate in community efforts to prevent first and subsequent adolescent pregnancies may benefit from recognizing that marijuana use and pregnancy may be co-occurring problems. Adolescents' perceptions of their boyfriends' level of desire for conception may also be an important predictor of pregnancy risk. The findings also suggest a possible protective effect of receiving TANF (Temporary Assistance to Needy Families) benefits; adolescent recipients of these programs may be more vigilant in their pregnancy prevention practices than those who are not recipients.
Crosby
Richard A
RA
Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA 30322, USA. rcrosby@sph.emory.edu
DiClemente
Ralph J
RJ
Wingood
Gina M
GM
Harrington
Kathy
K
Davies
Suzy
S
Hook
Edward W
EW
Oh
M Kim
MK
D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services; D001741:Black or African American; D000407:Alabama / Q000208:ethnology; D005260:Female; D006801:Humans; D011203:Poverty; D011237:Predictive Value of Tests; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology* / Q000517:prevention & control* / Q000523:psychology; D011314:Preventive Health Services; D011446:Prospective Studies; D011584:Psychology; D012725:Sexual Behavior; D012944:Social Support