Kahn J G, Brindis C D, Glei D A
Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.
Fam Plann Perspect. 1999 Jan-Feb;31(1):29-34.
The personal and social costs associated with teenage pregnancy in the United States concern many policymakers and researchers, yet the role of contraception in preventing these pregnancies has not been adequately quantified.
Published estimates of contraceptive effectiveness were applied to 1995 National Survey of Family Growth data on sexual and contraceptive practices in order to estimate the number of pregnancies averted through the use of contraceptives by U.S. teenagers. Four scenarios of contraceptives access--from current levels of access to highly restricted access--and teenagers' sexual and contraceptive practices in response to such restrictions are used to project the potential impact on pregnancies among teenagers.
Current levels of contraceptive use averted an estimated 1.65 million pregnancies among 15-19-year-old women in the United States during 1995. If these young women had been denied access to both prescription and over-the-counter contraceptive methods, an estimated one million additional pregnancies (ranging from 750,000 to 1.25 million) would have occurred, assuming some decrease in sexual activity. These pregnancies would have led to 480,000 live births, 390,000 abortions, 120,000 miscarriages, 10,000 ectopic pregnancies and 37 maternal deaths.
Contraceptive use by teenage women prevents pregnancies and negative pregnancy-related health consequences that can disrupt the lives of adolescent women and that have substantial societal costs. Continued and expanded access to contraceptives for adolescents is a critically important public health strategy.
在美国，青少年怀孕所带来的个人和社会成本令许多政策制定者和研究人员担忧，然而避孕措施在预防这些怀孕方面所起的作用尚未得到充分量化。
已发表的避孕效果评估数据应用于1995年全国家庭成长调查中关于性行为和避孕措施使用情况的数据，以估算美国青少年通过使用避孕措施避免怀孕的数量。采用四种避孕措施可及性情景——从当前可及水平到高度受限可及水平——以及青少年针对此类限制的性行为和避孕措施使用情况，来预测对青少年怀孕的潜在影响。
1995年，美国15至19岁女性当前的避孕措施使用情况估计避免了165万例怀孕。如果这些年轻女性无法获得处方和非处方避孕方法，假设性行为有所减少，估计还会额外发生100万例怀孕（范围在75万至125万例之间）。这些怀孕将导致48万例活产、39万例堕胎、12万例流产、1万例宫外孕和37例孕产妇死亡。
青少年女性使用避孕措施可预防怀孕以及与怀孕相关的负面健康后果，这些后果会扰乱青少年女性的生活并带来巨大的社会成本。持续并扩大青少年获得避孕措施的途径是一项至关重要的公共卫生策略。
