University of Illinois at Chicago, College of Medicine, Chicago, Illinois.
University of North Carolina at Chapel Hill, Carolina Population Center, Chapel Hill, North Carolina.
J Pediatr Adolesc Gynecol. 2024 Oct;37(5):510-515. doi: 10.1016/j.jpag.2024.06.002. Epub 2024 Jun 13.
Multiparous teens, compared to primiparous teens, are at increased risk for adverse neonatal and maternal outcomes. Long-acting reversible contraception (LARC) is infrequently used among postpartum teens. This study identifies predictors of teens' intentions to use LARC postpartum when it is widely available.
Colorado teens who were patients during their pregnancy in an adolescent-centered clinic where all common methods of contraception were easily accessible were surveyed in clinic during their third trimester and following delivery regarding life circumstances (relationships, stress, and family function) and intended method of postpartum contraception. Multinomial logistic regression analyses were used to examine predictors of intended postpartum contraceptive method: LARC, non-LARC effective (condoms, birth control pills, shot, patch, or ring), or low-effective method or no contraception (abstinence, no method, or undecided).
A total of 1203 patients were enrolled. Greater life stress was associated with greater likelihood of intending to use low-effective contraception versus LARC postpartum. Teens in a longer relationship with their baby's father (versus those never in a relationship with the baby's father) were less likely to intend to use low-effective contraception or non-LARC effective methods and more likely to intend to use LARC postpartum.
When structural barriers are minimized, non-clinical factors such as relationship context and life stress are most associated with postpartum LARC use intentions. Health care providers can help teen patients obtain the postpartum contraception the patients believe is best by employing developmentally appropriate, person-centered care that is sensitive to life stressors and relationship context.
与初产妇相比，多产妇青少年发生不良新生儿和产妇结局的风险增加。长效可逆避孕（LARC）在产后青少年中很少使用。本研究旨在确定当 LARC 广泛可用时，青少年产后使用 LARC 的意愿的预测因素。
在一家以青少年为中心的诊所中，对怀孕期间为患者的科罗拉多青少年进行调查，该诊所中所有常见的避孕方法都很容易获得。在妊娠晚期和分娩后，对青少年的生活情况（人际关系、压力和家庭功能）和产后避孕方法的意向方法进行了调查。采用多项逻辑回归分析来检验产后避孕方法的预期预测因素：LARC、非 LARC 有效（避孕套、避孕药、注射、贴片或环）或低有效方法或无避孕（禁欲、无方法或未决定）。
共纳入 1203 名患者。更大的生活压力与产后使用低有效避孕方法的可能性更大相关。与婴儿父亲关系时间较长的青少年（与婴儿父亲从未有过关系的青少年相比），她们更不可能使用低有效避孕方法或非 LARC 有效方法，而更有可能使用 LARC 产后避孕。
当结构障碍最小化时，非临床因素（如关系背景和生活压力）与产后 LARC 使用意愿最相关。医疗保健提供者可以通过采用适合发展阶段、以人为本的关怀，对生活压力源和关系背景敏感，帮助青少年患者获得她们认为最适合的产后避孕方法。
