Online Program

Unintended pregnancy risk among young women with psychological stress and depression symptoms

Wednesday, November 6, 2013 : 9:15 a.m. - 9:30 a.m.

Kelli Hall, PhD, MS, Department of Obstetrics and Gynecology; Population Studies Center, University of Michigan, Ann Arbor, MI
Yasamin Kusunoki, PhD, MPH, School of Nursing, University of Michigan, Ann Arbor, MI
Heather Gatny, University of Michigan, Ann Arbor, MI
Jennifer Barber, PhD, Department of Sociology, University of Michigan, Ann Arbor, MI
Objective: Our previous research demostrated the negative influence of young women's depression and stress symptoms on their contraceptive behavior. We further examined relationships between psychological symptoms and women's risk of unintended pregnancy. Methods: We used data from a longitudinal cohort study of 992 women ages 18-19 years, 97% of whom reported no intention of and a strong desire to avoid pregnancy. Weekly journals measured reproductive, relationship and health characteristics, contraceptive use, and pregnancy outcomes. We examined 27,610 journals from 978 women at risk of pregnancy during the first follow-up year. Our outcome was self-reported pregnancy. Predictors were baseline depression (CESD-5) and stress (PSS-4) (moderate/severe symptoms using score cut-offs). Random effects multivariate logistic regression was used to control for sociodemographic and reproductive covariates. Results: At baseline, 24% and 23% of women reported moderate/severe depression and stress symptoms, respectively. Ten percent of at-risk women became pregnant during the first study year (n=98); 93 women reported one pregnancy while 5 reported two pregnancies. Rates of pregnancy were higher among women with baseline depression (14% vs. 9%, p=0.04) and stress (14% vs. 9%, p=0.03) symptoms compared to women without symptoms. In multivariate models, women with baseline stress had an 8 times higher odds of pregnancy than those without stress (OR 8.1, CI 2.3-28.4, p=0.001). Depression did not predict pregnancy (OR 1.5, CI 0.5-4.7, p=0.65). Conclusion: Women with baseline moderate/severe stress symptoms experienced an elevated risk of unintended pregnancy over 1 year. Additional research will examine women's time-varying psychological symptoms throughout their unintended pregnancy experiences.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the effect of psychological symptoms on young women's risk of unintended pregnancy

Keyword(s): Pregnancy, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted several research studies focused on women's mental and reproductive health. I am also a family planning and adolescent health care provider.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.