Effects of Obstetric Complications on Adolescent Postpartum Contraception Choice and Rapid Repeat Pregnancy Rate [2O]

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Abstract

INTRODUCTION:

The study goals were to examine whether complications during pregnancy or at delivery influence postpartum contraception choices and rapid repeat pregnancy rates in adolescent women.

METHODS:

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 (LARC vs Non-LARC) at either delivery hospital discharge, or at postpartum outpatient appointment, and rapid repeat pregnancy rate (pregnancy confirmed within 12 months of index delivery), were analyzed by pregnancy complications. Comparisons were made with chi-squared and Fisher's exact tests for categorical variables, and with Wilcoxon rank sum test for continuous variables.

RESULTS:

Of the study population, 27.7% used LARC in the postpartum period. The LARC and non-LARC patient populations differed significantly regarding prior history of abortions (P=.029), with no differences in obstetric complications between the groups. 16.6% of the population became pregnant again within one year of their index delivery. Those with a rapid repeat pregnancy had significantly increased gravidity (P=.002), parity (P=.003), number of previous abortions (P=.026); they were also more like to have non live birth as a complication (P=.028), compared to those without repeat pregnancy. No other obstetrical complications were statistically significantly different between compared groups.

CONCLUSION:

Obstetrical complications seem to have little impact on postpartum contraception choice or repeat pregnancy rate with the notable exception of non live birth being associated with rapid repeat pregnancy. Counseling about postpartum contraception during prenatal care is crucial to reducing repeat pregnancy.

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