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

MedStar author(s):
Citation: Journal of Pediatric & Adolescent Gynecology. 28(1):57-62, 2015 Feb.PMID: 25555302Institution: MedStar Washington Hospital Center | MedStar Washington Hospital CenterDepartment: MedStar Heart Institute | Obstetrics and Gynecology/Pediatric and AdolescentForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Contraception Behavior/sn [Statistics & Numerical Data] | *Contraception/mt [Methods] | *Gravidity | *Postpartum Period | *Pregnancy in Adolescence/pc [Prevention & Control] | Adolescent | Female | Humans | Pregnancy | Pregnancy, Unplanned | Retrospective Studies | Time Factors | Young AdultYear: 2015Local holdings: Available online through MWHC library: 2002 - presentISSN:
  • 1083-3188
Name of journal: Journal of pediatric and adolescent gynecologyAbstract: 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.Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.DESIGN: Retrospective cohort study.INTERVENTIONS: None, study was retrospective.MAIN OUTCOME MEASURES: Repeat pregnancy within 2 years.PARTICIPANTS: 340 first-time adolescent mothers age < 19.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).SETTING: Urban teaching hospital.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.All authors: Damle LF, Desale SY, Gohari AC, Gomez-Lobo V, McEvoy AKFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2016-05-24
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 25555302 Available 25555302

Available online through MWHC library: 2002 - present

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.Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

DESIGN: Retrospective cohort study.

INTERVENTIONS: None, study was retrospective.

MAIN OUTCOME MEASURES: Repeat pregnancy within 2 years.

PARTICIPANTS: 340 first-time adolescent mothers age < 19.

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).

SETTING: Urban teaching hospital.

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.

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