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MONDAY, March 1 (HealthDayNews) -- Teens who use home pregnancy tests are less likely to be using contraception because they have fewer negative impressions regarding childbearing.

The authors of a study appearing in the March issue of Pediatrics suggest this may represent a red flag and a chance to counsel this particular group about childbearing expectations rather than contraceptive options.

The study authors looked at a group of 340 racially and ethnically diverse teens at three urban clinics in the southwestern United States. Each participant completed a questionnaire covering factors considered to be predictors of "inconsistent contraceptive use" and conception during adolescence. These factors included depression, self-esteem and family support.

Slightly more than a quarter, or 28 percent, of the participants had taken a home pregnancy test. Most (61 percent) had only done so once.

Answers to the questionnaires indicated that teenage girls who have taken at-home pregnancy tests were at higher risk for erratic use of birth control. They were also more likely to not be living with a biological parent, be at high risk for conceiving a baby, to have been sexually active for at least two years, to believe a boyfriend wanted them to be pregnant and not to have negative expectations about having a child as a teenager.

Furthermore, those who had taken home pregnancy tests were less likely to have used birth control the last time they had sex and more likely to refuse birth control during their clinic visit.

The mere fact of having taken a home pregnancy test should act as a red flag to health-care providers, the study authors assert. They should take the opportunity to offer more personalized counseling and discuss perceptions and expectations regarding having a child, rather than have the conventional talk about birth control options.

The findings and conclusions come as somewhat of a surprise to practitioners in the field, some of whom question the practicality of the findings.

"I can't recall in my own experience that I've had a young girl come in and say 'I've had a positive pregnancy test,'" says Dr. Michael Wasserman, a general pediatrician at the Ochsner Clinic Foundation in New Orleans. "I have had them say they missed a period or they've had a headache and they turned out to be pregnant."

On the other hand, Wasserman has found a disconcertingly high proportion of teenagers are passive about "pregnancy avoidance." This may be because some have a subconscious need or desire to get pregnant, he says.

"The use of a [home pregnancy] test obviously would be a red flag saying they're sexually active, but I'm not sure they're any less conversant or knowledgeable about birth control," says Wasserman, who refers his patients to an outside birth control counselor. "I think it's a useful tool and technique, but I don't see it used from a practical perspective."

More information

For more on teen pregnancy, visit the National Campaign to Prevent Teen Pregnancy. The American Social Health Association has more on sexually transmitted diseases.

(SOURCES: Michael Wasserman, general pediatrician, Ochsner Clinic Foundation, New Orleans; March 1, 2004, Pediatrics)

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