Implementing Interconception Care in a Dyadic Adolescent Mother-Child Clinic

Area of Science:

• Reproductive Health
• Adolescent Medicine
• Public Health

Background:

• Adolescent mothers face significant medical, socioeconomic, and educational challenges, exacerbated by subsequent pregnancies.
• Postpartum adolescents often use ineffective contraception despite the high efficacy of long-acting reversible contraception (LARC).
• Interconception care (ICC) aims to reduce maternal risks and promote healthy birth spacing, with pediatric visits offering a chance for LARC education.

Purpose of the Study:

• To analyze predictors of LARC initiation and repeat pregnancy in postpartum adolescents within an ICC framework.
• To evaluate the impact of visit frequency on LARC uptake and pregnancy outcomes.

Main Methods:

• Demographic and ICC screening data were collected from adolescent mothers at well-child visits (children aged 0-24 months).
• Logistic regression models were used to identify independent predictors of LARC initiation and repeat pregnancy.
• Study included analysis of mother-child dyad visit frequency.

Main Results:

• Adolescent mothers with at least two ICC visits were more likely to initiate LARC.
• Hispanic ethnicity and ≥2 visits were significant predictors of LARC initiation.
• Not initiating LARC was the sole independent predictor of repeat pregnancy; 5.5% of participants experienced a repeat pregnancy.

Conclusions:

• Optimal ICC requires consistent provider engagement, not just medical management, making it suitable for pediatric settings.
• Integrating pediatric and maternal healthcare is crucial for effective ICC implementation and improved adolescent maternal and child health outcomes.