Contraceptive Choices Pre and Post Pregnancy in Adolescence

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: 5958 - 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. Copyright (c) 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.