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Contraceptive choices pre and post pregnancy in adolescence
L Correia1, I Martins1, N Oliveira1
1Adolescence Unit of Maternity Dr. Alfredo da Costa - Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
Study Objective:
The main aim of this study is to evaluate the impact of adolescent pregnancy in the future contraceptive choices. A secondary aim is to verify whether these choices differ from those made after an abortion.
Design:
Retrospective study.
Setting:
Adolescent Unit of a tertiary care center.
Participants:
212 pregnant teenagers.
Interventions:
Medical records review.
Main Outcome Measures:
Intended pregnancy rate and contraceptive methods used before and after pregnancy. For contraceptive choices after pregnancy we considered: Group 1--teenagers who continued their pregnancy to delivery (n = 106) and Group 2--the same number of adolescents who chose to terminate their pregnancy.
Results:
The intended pregnancy rate was 14.2%. Prior to a pregnancy continued to delivery, the most widely used contraceptive method was the male condom (50.9%), followed by oral combined contraceptives (28.3%); 18.9% of adolescents were not using any contraceptive method. After pregnancy, contraceptive implant was chosen by 70.8% of subjects (P < .001) and the oral combined contraceptives remained the second most frequent option (17.9%, P = .058). Comparing these results with Group 2, we found that the outcome of the pregnancy was the main factor in the choices that were made. Thus, after a pregnancy continued to delivery, adolescents prefer the use of LARC [78.4% vs 40.5%, OR: 5,958 - 95% (2.914-12.181), P < .001)], especially contraceptive implants [70.8% vs 38.7%, OR: 4.371 - 95% (2.224-8.591), P < .001], to oral combined contraceptives [17.9% vs 57.5%, OR: 0.118 - 95% CI (0.054-0.258), P < .001].
Conclusion:
Adolescent pregnancy and its outcome constitute a factor of change in future contraceptive choice.
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