University of Massachusetts Medical School Faculty Publications

Title

Effects of Obstetric Complications on Adolescent Postpartum Contraception and Rapid Repeat Pregnancy

UMMS Affiliation

Department of Obstetrics and Gynecology; School of Medicine; Senior Scholars Program

Publication Date

12-1-2016

Document Type

Article

Disciplines

Female Urogenital Diseases and Pregnancy Complications | Obstetrics and Gynecology | Pediatrics | Women's Health

Abstract

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 chi2 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.

Rights and Permissions

Citation: J Pediatr Adolesc Gynecol. 2016 Dec;29(6):612-616. doi: 10.1016/j.jpag.2016.05.002. Epub 2016 May 21. Link to article on publisher's site

Comments

Gianna Wilkie participated in this study as a medical student in the Senior Scholars research program at the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

Keywords

Contraception use, Pregnancy in adolescence, Rapid repeat pregnancy

Journal/Book/Conference Title

Journal of pediatric and adolescent gynecology

PubMed ID

27222491