May 24, 2006 (Washington) — Nearly half of pregnant teens in an inner city population said they did not use birth control because they were "afraid they would not be able to get pregnant," researchers report.

In the study of 300 pregnant adolescents aged 12 to 19 years presenting for initial prenatal visits, a "remarkable" 42% said they had fears about not being able to get pregnant, said Emily M. White, MD, a resident at Women and Infants' Hospital in Providence, RI.

"While we hypothesized that these teens would be older, have a higher rate of previous sexually transmitted diseases (STDs), and have been sexually active longer, this also turned out not be to the case," she told Medscape.

"Surprisingly, the teens [who had fears about becoming pregnant] had similar demographic characteristics overall, and only slight differences in their health histories compared to their counterparts without this fear," Dr. White reported.

Each year, an estimated 800,000 US adolescents aged 15 to 19 years become pregnant and approximately 400,000 children are born to teens.

The findings were presented here at the annual meeting of the American College of Obstetricians and Gynecologists (ACOG).

For the study, the 300 teens underwent 30-minute face-to-face interviews by research assistants, with the main outcome determined by question, "Did you have any fears that you wouldn't be able to get pregnant?"

Of the 126 teens who had fears they could not become pregnant, just 17% used contraception. Of the 174 teens who were afraid they could become pregnant, 26% used contraception ( P = .09). "This is still an amazingly low rate of birth control use," Dr. White said.

Of those with a history of STDs, 25% thought they could not get pregnant compared with 21% of those with no such history ( P = .29).

Of those with prior pregnancies, 30% thought they could not get pregnant versus 29% with had not previously been pregnant ( P=0.87).

There was also no difference in fears among those who had been sexually active for more than 2.6 years vs those who had been sexually active for less than 2.0 years, Dr. White said.

While the problem might seem to be one of education, Dr. White said she does not believe that to be the case. "A pilot study showed that a lot of teens have sex without contraception and still don't get pregnant so they are just not worried," she said.

In addition, many have infertile family members, which leads them to worry that they, too, cannot get pregnant, she said.

Dr. White said she believes the adolescents are just indifferent to pregnancy. "It's not that they are trying to get pregnant, they are just indifferent. This is a bigger problem than education."

April Rubin, MD, a member of ACOG who is in private practice in Washington, DC, said she is not surprised by the findings. Also, like Dr. White, she does not think it is simply a matter of education or being misinformed.

"Some come from broken families and feel having a child will better fulfill their lives," she told Medscape. "What we need is not so much education but better social support and a way of giving these teens a better outlook on life," she said.

ACOG 54th Annual Clinical Meeting: Abstract 13S. Presented May 8, 2006.

Reviewed by Ursula Snyder, PhD

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