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Evaluating Unintended Pregnancy in Unmarried Female College Students

Major Finding: Having been in a physically abusive relationship within the past year was associated with a 2.8-fold increased risk of unintended pregnancy at 2-year schools and a 4.5-fold elevated risk at 4-year colleges.

Data Source: Data from the Spring 2007 National College Health Assessment.

Disclosures: Dr. Lindley said she had no relevant financial conflicts.


 

FROM THE ANNUAL MEETING OF THE AMERICAN PUBLIC HEALTH ASSOCIATION

DENVER – Unintended pregnancies are threefold more frequent among unmarried sexually active female college students at 2-year as opposed to 4-year institutions.

Data from the Spring 2007 National College Health Assessment showed that, overall, 2.6% of unmarried sexually active female students aged 18-24 years at western U.S. colleges experienced an unwanted pregnancy during the past year. The rate was 5.3% among 1,433 attendees at 2-year colleges and 1.8% in 4,732 at 4-year schools, Lisa L. Lindley, Dr.PH, reported at the annual meeting of the American Public Health Association.

A multivariate logistic regression analysis identified nine risk factors associated with unintended pregnancy in young women attending 2-year institutions and 11 risk factors operative at 4-year schools. Some of these risk factors were common to both types of schools, while others were unique to one or the other.

Among the most striking shared risk factors was having been in a physically abusive relationship within the past year. This was associated with a 2.8-fold increased risk of unintended pregnancy at 2-year schools and a 4.5-fold elevated risk at 4-year colleges, according to Dr. Lindley of George Mason University, Fairfax, Va.

Use of the emergency contraceptive pill within the previous year was another risk factor for unintended pregnancy common to students at both types of colleges. It was associated with a 2.6-fold increased risk in unmarried sexually active students at 2-year schools and a 2.8-fold risk in those at 4-year schools.

Having a C or lower grade average was associated with a 2.2-fold increased likelihood of unintended pregnancy in women attending a 4-year college, but was not a significant risk factor at 2-year colleges. On the other hand, having unprotected sex in the past year as a consequence of drinking alcohol was a significant risk factor for unintended pregnancy at 2-year, but not 4-year institutions. Having had a gynecologic exam during the past year was associated with a 2.7-fold increased likelihood of unintended pregnancy among women at 2-year schools but wasn’t a significant factor at 4-year colleges.

Race was not a significant predictor of unintended pregnancy among the college students. This is an intriguing finding in light of the marked racial disparity in pregnancy rates among young women as a whole in the United States, Dr. Lindley said. For example, in 2004 the pregnancy rates among 20- to -24-year-old black and Hispanic women were 259 and 245 per 1,000 population, respectively, compared with 123 per 1,000 in similarly aged white women.

Dr. Lindley explained that the college study was undertaken in an effort to better understand the phenomenon of unintended pregnancy. Half of all pregnancies in the United States are unintended. Among young unmarried women this figure is far higher: 73% among 20- to 24-year-olds, and 86% in those under age 20.

Solid progress has been made in reducing the national pregnancy rate among 15- to 17-year-olds. But pregnancy rates among 18- to 24-year-olds remain excessive, she said.

A key lesson from the college study lies in the importance of addressing multiple risk factors at once for unwanted pregnancy, including abusive relationships – physical, emotional, and sexual –as well as alcohol use and proper use of the emergency contraceptive pill, Dr. Lindley added.

She said she had no relevant financial interests.

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