Negative Test at Health Clinic Seen Indicator of Later Pregnancy

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When a teenage girl walks out of a health clinic with a negative pregnancy test, there's a good chance that she'll be back.

A new national study by Johns Hopkins University researchers found that one out of four girls who become pregnant by age 17 have had an earlier negative test result at a clinic.

At a time when targeting pregnancy-prevention efforts to the young women who need them most has become crucial as well as problematic, the findings suggest some prime candidates. For some teenage girls, a pregnancy test at a clinic may be "a cry for help," the authors say.

If girls receive counseling at the time of their first pregnancy tests, the researchers say, some pregnancies later on might be avoided.

The researchers studied about 2,800 girls age 17 or younger who sought pregnancy tests at 52 clinics in cities around the country.

The results from the study, conducted between 1992 and 1994, were published in the Jan. 10 Journal of the American Medical Association.

In questioning girls, the researchers found that almost one-third of those who had become pregnant had had at least one negative pregnancy test before they had a positive one. And almost one-fourth had done so at clinics where they could have been reached by organized pregnancy-prevention programs.

Why so many negative test results? Irregular menstrual cycles among teenagers prompted many to seek out the test, the article says. Such a common symptom "may provide a valuable opportunity to intervene" with many young women, the authors write.

Some teenagers in the study acknowledged they had little reason to believe they were pregnant but appeared at a clinic for a test anyway, the study found. "One can speculate that the visit may be a cry for help," the authors write.

Pam Johnson, the director of client services at Planned Parenthood of Southeast Michigan in Warren, agreed with the study's findings.

Often, she said, the first time a girl visits a clinic for gynecological services is for a pregnancy test or a pregnancy. "For those who get a negative test, it's imperative that some contraceptive-option counseling happen right then and there," she said.

"Because once they're out the door and feeling very lucky," Ms. Johnson added, "they will tend then to continue with risky behavior, and we'll see them again in six months for another test. And they may not be so fortunate."

Among urban schoolchildren, a substantial number of students carry weapons before they ever reach high school age. And, as they get older, they tend to graduate from sticks to knives to guns, a study by researchers in Baltimore has found.

Researchers at Johns Hopkins University and the Baltimore health department studied about 1,500 urban students in what the study referred to only as a mid-Atlantic city as they grew from age 9 to age 13.

The study, which appeared in the December issue of the Archives of Pediatric and Adolescent Medicine, was conducted from 1989 to 1993.

The researchers found that as children got older, fewer carried sticks and more carried knives and guns. In 1989, when the students were an average of 9 years old, 11.7 percent of boys and 3.3 percent of girls had carried a lethal weapon, at some point in the past year.

But by 1993, when the average age was 13, 22 percent of boys and 15 percent of girls said they had carried a knife or gun.

Carrying a stick or knife seemed to predict whether a student would carry a gun, the researchers found. Those who had carried a stick or club in 1991 were 12 times more likely than their peers to report for the first time in 1992 that they had carried a gun in the previous year.

Adolescents who suffer from chronic illnesses are more likely than their healthy peers to feel dissatisfied with their own bodies. As a result, they are more susceptible to unhealthy weight-loss practices, a University of Minnesota study has found.

The study, published in the December issue of the Archives of Pediatric and Adolescent Medicine, used information about 2,149 adolescent boys and girls with chronic illnesses and 1,381 adolescents without such illnesses.

Researchers at Minnesota's school of public health culled the data from a statewide health questionnaire completed by public school students in grades 7 through 12 during 1986-87.

Girls with diabetes, asthma, attention-deficit disorder, and seizure disorders had consistently higher rates of unhappiness with their bodies than healthy girls. A similar but less pronounced pattern appeared among boys with such illnesses.

Girls and boys with chronic illnesses also were more likely to eat in binges, diet frequently, and "purge" than their peers. Purging included vomiting or using laxatives, diuretics, or ipecac.

The exception was for girls with physical disabilities--they had lower rates of body dissatisfaction and unhealthy weight-loss practices than the healthy students in the control group. But the authors caution against drawing conclusions from those findings because of the small number of students with physical disabilities who were surveyed.

The researchers urged physicians and school staff members to discuss issues of body image and eating patterns with adolescents because unhealthy weight-control practices may lead to eating disorders.

--Millicent Lawton

Vol. 15, Issue 17

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