Rapid repeat pregnancy in adolescents: do immediate postpartum contraceptive implants make a difference?

Am J Obstet Gynecol. 2012 Jun;206(6):481.e1-7. doi: 10.1016/j.ajog.2012.04.015. Epub 2012 Apr 16.

Abstract

Objective: The purpose of this study was to determine contraceptive continuation and repeat pregnancy rates in adolescents who are offered immediate postpartum etonogestrel implant (IPI) insertion.

Study design: Participants in an adolescent prenatal-postnatal program were enrolled in a prospective observational study of IPI insertion (IPI group, 171) vs other methods (control group, 225). Contraceptive continuation and repeat pregnancies were determined.

Results: Implant continuation at 6 months was 96.9% (156/161 participants); at 12 months, the continuation rate was 86.3% (132/153 participants). At 6 months, 9.9% of the control participants were pregnant (21/213); there were no IPI pregnancies. By 12 months, 18.6% of control participants (38/204) experienced pregnancy vs 2.6% of IPI recipients (4/153; relative risk, 5.0; 95% confidence interval [CI], 1.9-12.7). Repeat pregnancy at 12 months was predicted by not receiving IPI insertion (odds ratio, 8.0; 95% CI, 2.8-23.0) and having >1 child (odds ratio, 2.1; 95% CI, 1.1-4.3; P = .03).

Conclusion: IPI placement in adolescents has excellent continuation 1 year after delivery; rapid repeat pregnancy is significantly decreased compared with control participants.

Publication types

  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Contraception / methods
  • Contraception / statistics & numerical data*
  • Contraceptive Agents, Female / administration & dosage*
  • Desogestrel / administration & dosage*
  • Drug Implants
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Postpartum Period*
  • Pregnancy / statistics & numerical data*
  • Prospective Studies
  • Time Factors
  • Young Adult

Substances

  • Contraceptive Agents, Female
  • Drug Implants
  • etonogestrel
  • Desogestrel