Pregnancy intentions and teenage pregnancy among Latinas: a mediation analysis.
BACKGROUND
The extent to which pregnancy intentions mediate the relationship between individual, familial and cultural characteristics and adolescent pregnancy is not well understood. The role of intentions may be particularly important among Latina teenagers, whose attitudes toward pregnancy are more favorable than those of other groups and whose pregnancy rates are high.


METHODS
Prospective, time-varying data from 2001-2004 were used to investigate whether two measures of pregnancy intentions, wantedness and happiness, mediated associations between risk factors and pregnancy among 213 Latina adolescents in San Francisco. Participants were tested for pregnancy and interviewed about pregnancy intentions, partnerships, family characteristics and activities every six months for two years. Associations and mediation were examined using logistic regression.


RESULTS
Neither pregnancy intention variable mediated relationships between participant characteristics and pregnancy. After adjustment for other measures, wantedness was strongly associated with pregnancy (odds ratio, 2.6), while happiness was not. Having a strong family orientation was associated with happiness (3.7) but unrelated to pregnancy. Low power in a sexual relationship with a main partner was associated with an elevated risk of pregnancy (3.3). If the pregnancy intentions of all participants were changed to definitely not wanting pregnancy, the estimated decline in pregnancy risk would be 16%.


CONCLUSIONS
Pregnancy intentions were important not as mediators but rather as independent risk factors for pregnancy. Differences in pregnancy rates between groups of Latinas may be less a function of intentional choice than of situational factors. Interventions and research should focus on identifying and targeting factors that hinder effective contraceptive use among teenagers who want to avoid pregnancy.
Rocca
Corinne H
CH
Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, CA, USA. roccac@obgyn.ucsf.edu
Doherty
Irene
I
Padian
Nancy S
NS
Hubbard
Alan E
AE
Minnis
Alexandra M
AM
D000293:Adolescent; D000294:Adolescent Behavior; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D033182:Intention; D007407:Interviews as Topic; D008297:Male; D017008:Negotiating; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology*; D011446:Prospective Studies; D012495:San Francisco; D055815:Young Adult