Effects of Obstetric Complications on Adolescent Postpartum Contraception and Rapid Repeat Pregnancy
| Autor: | Tiffany A. Moore Simas, Katherine Leung, Gianna Wilkie, Erin Barlow, Tara Kumaraswami |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Adolescent Pregnancy Rate media_common.quotation_subject Population Gravidity Fertility Abortion Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans 030212 general & internal medicine education Contraception Behavior Retrospective Studies media_common Gynecology education.field_of_study 030219 obstetrics & reproductive medicine Obstetrics business.industry Postpartum Period Obstetrics and Gynecology Abortion Induced Retrospective cohort study General Medicine Delivery Obstetric medicine.disease Pregnancy Complications Parity Pregnancy rate Contraception Family planning Pregnancy in Adolescence Pediatrics Perinatology and Child Health Female business Postpartum period |
| Zdroj: | Journal of Pediatric and Adolescent Gynecology. 29:612-616 |
| ISSN: | 1083-3188 |
| DOI: | 10.1016/j.jpag.2016.05.002 |
| Popis: | Study Objective To determine whether complications during pregnancy or at delivery influence postpartum contraception choices and rapid repeat pregnancy rates in adolescent women. Design, Setting, Participants, Interventions, and Main Outcome Measures This retrospective cohort study included 321 adolescents delivering at UMASS Memorial Healthcare. Complications during pregnancy and delivery along with subsequent contraception use were investigated. Postpartum contraception choice (long-acting reversible contraception [LARC] vs non-LARC) at either delivery, hospitalization discharge, or at postpartum outpatient appointment, and rapid repeat pregnancy rate (pregnancy confirmed within 12 months of index delivery), were analyzed according to pregnancy complications. Comparisons were made with χ 2 and Fisher exact tests for categorical variables, and with Wilcoxon rank sum test for continuous variables. Results Of the study population, 27.7% (n = 89/321) used LARC in the postpartum period. The LARC and non-LARC patient populations differed significantly regarding history of abortion ( P = .029), with no differences in obstetric complications between the groups. Of the population, 16.6% (n = 53/320) became pregnant again within 1 year of their index delivery. Those with a rapid repeat pregnancy had significantly increased gravidity ( P = .002), parity ( P = .003), number of previous spontaneous or therapeutic abortions ( P = .026); they were also more like to have nonlive birth as a complication ( P = .028), compared with those without repeat pregnancy. No other obstetrical complications were statistically significantly different between the compared groups. Conclusion Obstetrical complications seem to have little effect on postpartum contraception choice or repeat pregnancy rate with the notable exception of nonlive birth being associated with rapid repeat pregnancy. |
| Databáze: | OpenAIRE |
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