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J Pediatr Adolesc Gynecol. 2015 Feb;28(1):57-62. doi: 10.1016/j.jpag.2014.04.005. Epub 2014 May 5.

Early initiation of postpartum contraception: does it decrease rapid repeat pregnancy in adolescents?

Author information

1
MedStar Washington Hospital Center, Department of Women and Infant Services, Washington, DC. Electronic address: Lauren.F.Damle@medstar.net.
2
MedStar Washington Hospital Center, Department of Women and Infant Services, Washington, DC.
3
MedStar Washington Hospital Center, Department of Women and Infant Services, Washington, DC; Georgetown University School of Medicine, Washington, DC.
4
MedStar Health Research Institute, Washington, DC.
5
MedStar Washington Hospital Center, Department of Women and Infant Services, Washington, DC; Department of Pediatric Surgery, Children's National Medical Center, Washington, DC.

Abstract

STUDY OBJECTIVE:

Rapid repeat adolescent pregnancy is a significant public health concern. An effective and practical means of decreasing unintended second adolescent pregnancies needs to be identified. The objective of this study is to determine if early initiation of contraception, and in particular long acting reversible contraception (LARC), decreases rapid repeat pregnancy among first time adolescent mothers.

DESIGN:

Retrospective cohort study.

SETTING:

Urban teaching hospital.

PARTICIPANTS:

340 first-time adolescent mothers age ≤ 19.

INTERVENTIONS:

None, study was retrospective.

MAIN OUTCOME MEASURES:

Repeat pregnancy within 2 years.

RESULTS:

340 first time adolescent mothers with a documented follow-up time of 2 years had a repeat pregnancy rate of 35%. Average time from delivery to repeat pregnancy was 9.9 ± 6.4 months. Logistic regression analysis comparing adolescents with and without repeat pregnancy revealed that leaving the hospital postpartum without initiating any contraception was associated with significant increase risk of repeat pregnancy (OR = 2.447, 95% CI 1.326-4.515). Follow-up within 8 weeks postpartum was associated with lower chance of repeat pregnancy (OR = 0.322, 95% CI 0.172-0.603). Initiation of a LARC method (either an intrauterine device or etonogestrel subdermal implant) by 8 weeks postpartum was also associated with decreased chance of rapid repeat pregnancy (OR = 0.118, 95% CI 0.035-0.397).

CONCLUSION:

Adolescent mothers who initiate a LARC method within 8 weeks of delivery are less likely to have a repeat pregnancy within 2 years than those who choose other methods or no method. First time adolescent mothers should be counseled about this advantage of using LARC.

KEYWORDS:

Adolescent pregnancy; Contraception; Intrauterine device; Long acting reversible contraception; Subdermal contraceptive implant; Unintended pregnancy

PMID:
25555302
DOI:
10.1016/j.jpag.2014.04.005
[Indexed for MEDLINE]

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