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在一项综合性青少年父母项目中,青少年重复怀孕情况显著减少。

Significant reduction of repeat teen pregnancy in a comprehensive young parent program.

作者信息

Omar H A, Fowler A, McClanahan K K

机构信息

Department of Pediatrics, University of Kentucky, Lexington, Kentucky, USA.

出版信息

J Pediatr Adolesc Gynecol. 2008 Oct;21(5):283-7. doi: 10.1016/j.jpag.2007.08.003.

Abstract

OBJECTIVE

To describe a comprehensive, multidisciplinary approach to teen mothers and their children that significantly reduces repeat pregnancies.

DESIGN

Retrospective review of repeat teen pregnancy data.

SETTING

Young Parent Program (YPP) at a university-based health center.

PARTICIPANTS

1386 teen mothers between the ages of 11 and 19 who participated in the YPP for at least three years.

INTERVENTION

Comprehensive Care: for both teen mother and her baby, including prenatal and postnatal care, preventive care, reproductive services, mental health, and acute care visits. Family counseling and similar services were also provided to siblings of the teen. CONTINUITY OF CARE: Patients are seen by the same staff and attending physicians on each visit. The treatment team includes physicians, nurses, social worker, nutritionist, and psychologist, all of whom are available to provide care at each visit. Flexible hours: Including evening clinic to allow teens to attend school or work during the day. Financial incentive: Patients with no insurance are given free contraceptives and a "no charge" clinic visit. Extensive contraceptive counseling is provided prior to start of contraceptive use and at every clinic visit. Routine telephone and/or mail reminders of appointments

MAIN OUTCOME MEASURE

Rate of repeat teen pregnancy.

RESULTS

Only 11(.79%) had repeat pregnancies. Older youth appeared more likely to repeat a pregnancy.

CONCLUSION

Comprehensive intervention for teen mothers can be very successful in reducing repeat teen pregnancy in those teens who participate consistently in the program over a period of years.

摘要

目的

描述一种针对青少年母亲及其子女的全面、多学科方法,该方法能显著减少重复妊娠。

设计

对重复青少年妊娠数据进行回顾性分析。

地点

一家大学健康中心的青年父母项目(YPP)。

参与者

1386名年龄在11至19岁之间、参与YPP至少三年的青少年母亲。

干预措施

全面护理:为青少年母亲及其婴儿提供包括产前和产后护理、预防保健、生殖服务、心理健康及急症护理就诊等服务。还为青少年的兄弟姐妹提供家庭咨询及类似服务。连续护理:每次就诊时患者由相同的工作人员和主治医生接待。治疗团队包括医生、护士、社会工作者、营养师和心理学家,每次就诊时他们均可提供护理服务。灵活的工作时间:包括开设夜间门诊,以便青少年白天能上学或工作。经济激励:没有保险的患者可获得免费避孕药具及一次“免费”门诊就诊机会。在开始使用避孕药具前及每次门诊就诊时提供广泛的避孕咨询服务。通过电话和/或邮件定期提醒预约就诊。

主要观察指标

青少年重复妊娠率。

结果

只有11人(0.79%)出现重复妊娠。年龄较大的青少年似乎更有可能再次怀孕。

结论

对于那些多年来持续参与该项目的青少年母亲,全面干预在减少青少年重复妊娠方面可能非常成功。

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