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Biomedical subjects

Catherine Stevens-Simon

Publications and source records attributed to Catherine Stevens-Simon.

9 recordsLinked to original sources
PubMed2004

Paradoxical adolescent reproductive decisions.

OBJECTIVE: To determine why teenagers who say they do not plan to parent if they become pregnant fail to use contraceptives consistently enough to avoid conceiving by default. METHODS: A racially diverse group of 333 inadequately contracepting, nulligravida teens, 45 (13.5%) of whom did not plan to parent if they became pregnant was studied. Participants completed scales assessing traditional teen pregnancy risk factors, deterrents to contraceptive use, expectations about the effect of pregnancy, the desire to remain non-pregnant, and sexual behavior. RESULTS: Teens who said they would not parent if pregnant were less apt to report boyfriends who wanted them to conceive (RR=0.7; 95% CI=0.5-0.9) and deterrents to contraceptive use (RRs around: 0.6; 95% CI: 0.3-0.9) and more apt to anticipate that childbearing would negatively impact their lives (RR: 1.9; 95% CI: 1.6-2.2), to want to remain non-pregnant (RR: 2.2; 95% CI: 1.8-2.4), and to have used contraception at last sexual intercourse (RR: 1.8; 95% CI: 1.3-2.4). In the group that did not intend to parent the only difference between those who had and had not used contraception at last intercourse was their willingness to plan for sexual activity (OR: 4.6; 95% CI: 1.3-16.7). CONCLUSION: This study suggests that further progress toward preventing unwanted teen pregnancies might be made by dispelling the notion that for young, unmarried women, unplanned sexual intercourse is preferable to planned sexual intercourse.

Adolescent↗
PubMed2004

Teen home pregnancy test takers: more worried or more wishful?

OBJECTIVE: To test the hypothesis that teenagers who have taken home pregnancy tests are more ambivalent about remaining nonpregnant than those who have not and, for this reason, use contraceptives less consistently. METHODS: A racially diverse group of 340 inadequately contracepting, nulligravida teens, 94 (28%) of whom had taken a home pregnancy test, was studied. At enrollment, participants completed a self-administered questionnaire, were counseled about contraceptive options, and were given the opportunity to initiate their method of choice. The enrollment tool assessed traditional teen-pregnancy risk factors, expectations about the effects of childbearing, common deterrents to contraceptive use, the desirability of remaining nonpregnant, and contraceptive use and plans. RESULTS: Home pregnancy test takers were more apt to be unsure that they wanted to remain nonpregnant (relative risk [RR]:1.3; 95% confidence interval [CI]:1.1-1.6), principally because they were more likely to lack negative expectations about the effects of childbearing on their lives (odds ratio: 2.2; 95% CI = 1.2-4.0). Although no more likely to perceive deterrents to contraceptive use, pregnancy-test-kit users were more apt to have had unprotected sexual intercourse in the past (RR:1.3; 95% CI:1.1-1.5) and to plan to do so in the future (RR:1.7; 95% CI:1.1-3.3). Group differences in the desire to remain nonpregnant accounted for differences in contraceptive behavior and plans. CONCLUSION: Home pregnancy test taking should be regarded as a red flag by those who care for adolescents; although they are as capable of using contraceptives as their peers, test takers are less apt to do so because they expect less negative consequences from childbearing and, for this reason, may benefit more from discussing childbearing expectations than contraceptive options.

Adolescent↗
PubMed2002

Limb pain associated with an undiagnosed hemoglobinopathy and pseudononcyesis.

Over a 2-month period, a 16-yr-old African-American female presented with recurrent episodes of severe, migratory limb pain. Sickle cell C disease was ultimately diagnosed. She adamantly denied sexual activity but was found to be 28 weeks pregnant. Her limb pain was probably triggered by the metabolic and hemodynamic demands of pregnancy. The case illustrates the importance of thoroughly examining patients with recurrent, unexplained physical complaints.

Adolescent↗
PubMed2002

Does incomplete growth and development predispose teenagers to preterm delivery? A template for research.

Pregnant teenagers are in better physical condition, suffer from fewer chronic diseases, and engage in fewer health-risky behaviors than socioeconomically similar pregnant adults, but give birth to a disproportionately large number of preterm infants. This systematic review of the adolescent pregnancy literature defines the unique risks associated with being young and pregnant by examining how the physical and psychosocial changes that are characteristic of puberty and adolescence interact with traditional risk factors for preterm delivery. The need for age-specific interventions is discussed and recommendations for future research are made.

Adolescent↗
PubMedDate not supplied

Is this patient insulin resistant? How much does it matter?

Alex was an obese 10-year-old girl with a family history of type 2 diabetes, hypertension, and perhaps polycystic ovarian syndrome. Her physical examination was significant for a central accumulation of body fat and acanthosis nigricans. Although the laboratory studies indicated that Alex was not diabetic and probably not glucose intolerant, she could be insulin resistant (IR). Should any further evaluation be done? If Alex is IR, what kind of treatment should be offered? The following discussion addresses these questions by reviewing the pathophysiology, diagnosis, and consequences of isolated IR.

Acanthosis Nigricans↗