Desire to Avoid Pregnancy scale: clinical considerations and comparison with other questions about pregnancy preferences

Background Clinicians and women of reproductive

age would benefit from a reliable way to identify

who is likely to become pregnant in the next year,

in order to direct health advice. The 14-item Desire

to Avoid Pregnancy (DAP) scale is predictive of

pregnancy; this paper compares it with other ways

of assessing pregnancy preferences to shortlist

options for clinical implementation.

Methods A cohort of 994 UK women of

reproductive age completed the DAP and other

questions about pregnancy preferences, including

the Attitude towards Potential Pregnancy Scale

(APPS), at baseline and reported on pregnancies

quarterly for a year. For each question, DAP item

and combinations of DAP items, we examined the

predictive ability, sensitivity, specificity, area under

the receiver operating curve (AUROC), and positive

and negative predictive values.

Results The AUROCs and predictive ability of the

APPS and DAP single items were weaker than the

full DAP, though all except one had acceptable

AUROCs (>0.7). The most predictive individual

DAP item was ‘It would be a good thing for me if

I became pregnant in the next 3months’, where

women who strongly agreed had a 66.7% chance

of pregnancy within 12 months and the AUROC

was acceptable (0.77).

Conclusion We recommend exploring the

acceptability to women and healthcare professionals

of asking a single DAP item (‘It would be a good

thing for me if I became pregnant in the next

3months’), possibly in combination with additional

DAP items. This will help to guide service provision

to support reproductive preferences