Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials
Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials
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DOI：
10.1136/bmj.324.7351.1426
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发表时间：
2002-06-15
影响因子：
105.7
通讯作者：
Griffith, L
中科院分区：
文献类型：
--
作者：
DiCenso, A;Guyatt, G;Griffith, L
目的 回顾旨在延迟性交、改善节育措施的使用和减少青少年意外怀孕发生率的一级预防策略的有效性。数据来源 12 个电子书目数据库、10 种重要期刊、相关文章的引用以及与作者的联系。研究选择 22 份已发表和未发表的报告中描述的 26 项试验，将青少年随机分配到干预组或对照组（替代干预或无）。数据提取 两名独立评审员评估方法学质量和结果数据综合 干预措施不会延迟年轻女性（汇总优势比 1.12；95% 置信区间 0.96 至 1.30）或年轻男性（0.99；0.84 至 1.16）的性交开始；年轻女性在每次性行为（0.95；0.69至1.30）或最后一次性行为（1.05；0.50至2.19）或年轻男性在每次性行为（0.90；0.70至1.16）或最后一次性行为（1.25；0.99至1.59）时使用节育措施并没有改善；并且没有降低年轻女性的怀孕率（1.04；0.78至1.40）。四项禁欲计划和一项学校性教育计划与年轻男性参与者的伴侣怀孕次数增加有关（1.54；1.03 至 2.29）。接受多方面计划的年轻女性的怀孕率显着减少（0.41、0.20 至 0.83），尽管本研究中的基线差异有利于干预措施。 结论 迄今为止评估的一级预防策略并未延迟性交的开始、改善年轻男性和女性长期避孕的使用或减少年轻女性的怀孕数量。
Objective To review the effectiveness of primary prevention strategies aimed at delaying sexual intercourse, improving use of birth control, and reducing incidence of unintended pregnancy in adolescents.Data sources 12 electronic bibliographic databases, 10 key journals, citations of relevant articles, and contact with authors.Study selection 26 trials described in 22 published and unpublished reports that randomised adolescents to an intervention or a control group (alternate intervention or nothing).Data extraction Two independent reviewers assessed methodological quality and abstracted data.Data synthesis The interventions did not delay initiation of sexual intercourse in young women (pooled odds ratio 1.12; 95% confidence interval 0.96 to 1.30) or young men (0.99; 0.84 to 1.16); did not improve use of birth control by young women at every intercourse (0.95; 0.69 to 1.30) or at last intercourse (1.05; 0.50 to 2.19) or by young men at every intercourse (0.90; 0.70 to 1.16) or at last intercourse (1.25; 0.99 to 1.59); and did not reduce pregnancy rates in young women (1.04; 0.78 to 1.40). Four abstinence programmes and one school based sex education programme were associated with an increase in number of pregnancies among partners of young male participants (1.54; 1.03 to 2.29). There were significantly fewer pregnancies in young women who received a multifaceted programme (0.41, 0.20 to 0.83), though baseline differences in this study favoured the intervention.Conclusions Primary prevention strategies evaluated to date do not delay the initiation of sexual intercourse, improve use of birth control an-long young men and women, or reduce the number of pregnancies in young women.