Follow-up of pregnant teens at a hospital-based clinic

Our study investigates the factors associated with length of time to referral appointments for pregnant teens diagnosed in a hospital-based adolescent clinic.

Ninety-six pregnancies diagnosed during a six-month period at a hospital-based adolescent clinic were followed prospectively. Demographic data, plans for pregnancy, last menstrual period (LMP), and who accompanied patient to the appointment were recorded by providers. Appointment at referral site was confirmed by the patients' primary provider, contact with the patient, and/or referral site. The time from first positive pregnancy test to kept referral appointment was determined.

Of the 96 diagnosed pregnancies, data were available for 94 patients. The mean age was 17.6 +/- 2.0 years. The average gestation was 7.4 +/- 4.2 weeks (range 4-27 weeks) at initial visit and 11.7 +/- 4.9 weeks (5-30 weeks) at referral site. The time to referral appointment was significantly shorter for patients who planned to terminate compared with those who planned to continue with the pregnancy (22.4 +/- 16.6 vs. 35.7 +/- 24.5 days, P = 0.0042). However, the final decision to continue vs. terminate the pregnancy was a stronger predictor of the interval to kept referral appointment (R2 = 0.177) than the initial plan. Those who planned to tell more people about their pregnancy had a significantly higher rate of continuing the pregnancy than those terminating.

Pregnant teens may need multiple follow-up appointments to facilitate connection to referral care. Close follow-up and communication with referral sites needed to optimize care of pregnant teens because of the delay until teens access pregnancy services.