Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Am J Obstet Gynecol. 2012 Jun;206(6):481.e1-7. doi: 10.1016/j.ajog.2012.04.015. Epub 2012 Apr 16.
The purpose of this study was to determine contraceptive continuation and repeat pregnancy rates in adolescents who are offered immediate postpartum etonogestrel implant (IPI) insertion.
Participants in an adolescent prenatal-postnatal program were enrolled in a prospective observational study of IPI insertion (IPI group, 171) vs other methods (control group, 225). Contraceptive continuation and repeat pregnancies were determined.
Implant continuation at 6 months was 96.9% (156/161 participants); at 12 months, the continuation rate was 86.3% (132/153 participants). At 6 months, 9.9% of the control participants were pregnant (21/213); there were no IPI pregnancies. By 12 months, 18.6% of control participants (38/204) experienced pregnancy vs 2.6% of IPI recipients (4/153; relative risk, 5.0; 95% confidence interval [CI], 1.9-12.7). Repeat pregnancy at 12 months was predicted by not receiving IPI insertion (odds ratio, 8.0; 95% CI, 2.8-23.0) and having >1 child (odds ratio, 2.1; 95% CI, 1.1-4.3; P = .03).
IPI placement in adolescents has excellent continuation 1 year after delivery; rapid repeat pregnancy is significantly decreased compared with control participants.
本研究旨在确定为产后即刻提供依托孕烯植入物（IPI）的青少年的避孕续用率和重复妊娠率。
参与青少年产前-产后项目的参与者被纳入一项关于 IPI 插入术（IPI 组，171 名）与其他方法（对照组，225 名）的前瞻性观察性研究。确定避孕续用和重复妊娠情况。
植入物在 6 个月时的续用率为 96.9%（156/161 名参与者）；在 12 个月时，续用率为 86.3%（132/153 名参与者）。在 6 个月时，对照组中有 9.9%的参与者怀孕（21/213）；没有 IPI 妊娠。在 12 个月时，对照组中有 18.6%的参与者（38/204）怀孕，而 IPI 组仅有 2.6%（4/153）怀孕（相对风险，5.0；95%置信区间[CI]，1.9-12.7）。12 个月时再次怀孕的预测因素为未接受 IPI 插入术（优势比，8.0；95%CI，2.8-23.0）和有>1个孩子（优势比，2.1；95%CI，1.1-4.3；P=0.03）。
青少年产后即刻放置 IPI 的 1 年后续用率很高；与对照组相比，重复妊娠率显著降低。
