title: Ambivalence about pregnancy and its association with symptoms of depression in adolescent females initiating contraception.
abstract: OBJECTIVE
  To examine the association between symptoms of depression and ambivalence about pregnancy in an inner-city adolescent female population.
  
  
  METHODS
  This study analyzed data from 220 urban minority adolescent females (ages, 15-19 years) presenting for contraceptive initiation in a comprehensive, free-of-cost, adolescent health center in New York City. Cross-sectional baseline data were examined to define the relationship between participants' ambivalence toward pregnancy (defined by responses to items previously used in the National Longitudinal Study of Adolescent Health) and symptoms of depression (assessed by the Center for Epidemiological Studies-Depression scale). After controlling for covariates, multivariate logistic regression was used to identify the unique contribution of symptoms of depression on the pregnancy ambivalent group.
  
  
  RESULTS
  Over one third of adolescent females self-reported ambivalence about pregnancy (n = 73, 33%). In our sample, 20% (n = 45) reported mild and 14% (n = 30) reported moderate-to-severe symptoms of depression. After controlling for potentially confounding factors, adolescent females who reported mild symptoms of depression had increased odds of reporting pregnancy ambivalence (adjusted odds ratio, 3.53; confidence interval, 1.64-7.62; p = .001) compared with those with minimal symptoms of depression.
  
  
  CONCLUSIONS
  A substantial number of adolescents, despite planning to initiate contraception, were ambivalent about pregnancy; those reporting ambivalence were more likely to report mild symptoms of depression. When counseling adolescents about contraception initiation, clinicians should be aware that mild symptoms of depression may contribute to ambivalence about pregnancy.
authors.affiliation: Department of Pediatrics, Division of Adolescent Medicine, Mount Sinai Adolescent Health Center, New York, New York. Electronic address: jf2815@cumc.columbia.edu.
authors.forename: Jenny
authors.initials: J
authors.lastname: Francis
authors.affiliation: Tribeca Pediatrics, New York, New York.
authors.forename: Katherine
authors.initials: K
authors.lastname: Malbon
authors.affiliation: Department of Pediatrics, Division of Adolescent Medicine, Mount Sinai Adolescent Health Center, New York, New York.
authors.forename: Debra
authors.initials: D
authors.lastname: Braun-Courville
authors.affiliation: Department of Pediatrics, Division of Adolescent Medicine, Mount Sinai Adolescent Health Center, New York, New York.
authors.forename: Linares Oriana
authors.initials: LO
authors.lastname: Lourdes
authors.affiliation: Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: John
authors.initials: J
authors.lastname: Santelli
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D003267:Contraception / Q000523:psychology; D003268:Contraception Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D009519:New York City; D016017:Odds Ratio; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control* / Q000523:psychology*; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Ambivalence about pregnancy; Birth control sabotage; Contraception; Depressive symptoms; Mental health; Pregnancy attitudes; Pregnancy intentions; Symptoms of depression