A village would be nice but...it takes a long-acting contraceptive to prevent repeat adolescent pregnancies.
A village would be nice but...it takes a long-acting contraceptive to prevent repeat adolescent pregnancies.
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一个村庄固然不错，但是……需要长效避孕药才能防止青少年再次怀孕。
DOI：
10.1016/s0749-3797(01)00316-6
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发表时间：
2001
影响因子：
5.5
通讯作者：
Kulick,R
中科院分区：
文献类型：
--
作者：
Stevens-Simon,C;Kelly,L;Kulick,R
目的确定一个全面的、多学科的、以青少年为导向的产妇方案的哪些组成部分可以帮助少女母亲推迟随后的怀孕。设计/环境/患者在一项综合性、多学科、以青少年为导向的产科项目中，对373名参与者进行了研究。干预：该项目旨在通过简化获得避孕药具的途径来直接预防迅速怀孕，并通过劝阻辍学和鼓励从事与生育间隔较短不相容的职业来间接预防迅速怀孕。父母和孩子在一起；在产后第一年安排了9次访问，第二年安排了4次访问。主要结局指标：少女重复怀孕。结果1年和2年的重复妊娠率分别为14%和35%。怀孕的少女母亲表现出明显更多的重复怀孕风险因素，但与未怀孕的同龄人一样，她们对诊所就诊的依从性相同。青少年在产褥期所做的避孕选择对她们后来的生育能力有最深远的影响。logistic回归分析发现产床期间未使用Norplant是产后头两年重复妊娠的最强预测因子（相对危险度[RR]=8.89； 95%可信区间[CI]= 2.80-28.50）。出现9个及以上重复妊娠危险因素（RR=2.37; 95% CI= 1.38-4.06）和产褥期未使用depoo - provera （RR=2.30; 95% CI= 1.60-3.29）也预测重复妊娠，但就诊和产后重返学校与重复妊娠无关。结论产褥期使用长效激素避孕药与产后2年的妊娠预防有关，但频繁的门诊就诊、与支持性医疗保健和社会服务提供者的联系以及重返学校与预防妊娠无关。
ObjectiveTo determine which components of a comprehensive, multidisciplinary, adolescent-oriented maternity program help teenage mothers delay subsequent pregnancies.Design/ Setting/ PatientsA cohort of 373 participants in a comprehensive, multidisciplinary, adolescent-oriented maternity program was studied.InterventionThe program was designed to prevent rapid subsequent pregnancies directly by simplifying access to contraceptives and indirectly by discouraging school drop-out and encouraging the pursuit of careers incompatible with closely spaced childbearing. Parents and children were seen together; nine visits were scheduled during the first postpartum year and four visits during the second year.Main Outcome MeasureRepeat adolescent pregnancy.ResultsThe repeat pregnancy rate was 14% at 1 year and 35% at 2 years. Teenage mothers who became pregnant exhibited significantly more repeat pregnancy risk factors but were as compliant with clinic visits as their nonpregnant peers. The contraceptive choices the teenagers made during the puerperium had the most profound effect on their subsequent fertility. A logistic regression analysis identified failure to use Norplant during the puerperium as the strongest predictor of repeat pregnancy during the first 2 postpartum years (relative risk [RR]=8.89; 95% confidence interval [CI]=2.80–28.50). Exhibiting nine or more repeat pregnancy risk factors (RR=2.37; 95% CI=1.38–4.06) and not using Depo-Provera during the puerperium (RR=2.30; 95% CI=1.60–3.29) also predicted repeat conception, but clinic visits and return to school postpartum did not.ConclusionsUsing a long-acting hormonal contraceptive during the puerperium was associated with pregnancy prevention during the first 2 postpartum years, but frequent clinic visits, contact with supportive healthcare and social service providers, and return to school were not.