Rapid repeat pregnancy in adolescents: do immediate postpartum contraceptive implants make a difference? Reasons For First Teen Pregnancies Predict the Rate of Subsequent Teen Conceptions Postpartum Contraceptive Use Among Adolescent Mothers Social ecological predictors of repeat adolescent pregnancy. Delaying Second Births Among Adolescent Mothers: A Randomized, Controlled Trial of a Home-Based Mentoring Program Predictors of sexual intercourse and rapid-repeat pregnancy among teenage mothers: an Australian prospective longitudinal study. Low parental monitoring predicts subsequent pregnancy among African-American adolescent females. Pre-teen literacy and subsequent teenage childbearing in a US population.
OBJECTIVE 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 .  STUDY DESIGN Participants in an adolescent prenatal-postnatal program were enrolled in a prospect i ve observational study of  IPI insertion ( IPI group , 171 ) vs  other methods ( control group , 225 ) .  Contraceptive continuation and repeat pregnancies were determined . RESULTS 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 ) . CONCLUSION IPI placement in adolescents has excellent continuation 1 year after delivery ; rapid repeat pregnancy is significantly decreased compared with control participants Objective . To identify reasons for inconsistent contraceptive use that ante date conception and continue to predispose participants in adolescent-oriented maternity programs to unsafe sexual practice s after delivery . We hypothesized that teens who attributed their failure to use  contraceptives before their first conception exclusively to concerns about their side effects and /or their own lack of motivation to prevent conception would report less consistent  contraceptive use and more repeat conceptions than would teens who attributed their previous failure to use contraceptives to their lack of capacity to do so . Method . We conducted a 2-year , prospect i ve , longitudinal study of contraceptive use and repeat conceptions in a racially/ethnically diverse population of poor 13- to 18-year-olds . The 198 study participants were enrolled consecutively during their first pregnancies from an adolescent-oriented maternity program .  Results . The majority ( 84 % ) of the teens attributed their failure to use  contraceptives  before their first pregnancy partially to a lack of capacity to do so . As hypothesized , these teen mothers were significantly more likely to use hormonal contraceptives  ( 85 % vs 62 % ) , ( particularly Norplant , 47 % vs 19 % ) and less likely to conceive again ( 13 % vs 41 % ) . Most teens attributed their inconsistent contraceptive use during the postpartum study period to three factors : side effects , plans to abstain from sexual intercourse , and their lack of motivation to postpone additional childbearing . Conclusions . The reasons teen mothers give for not using contraceptives consistently before their first pregnancies predict the occurrence of subsequent conceptions during adolescence . Those who attribute their previous failure to use contraceptives consistently to side-effect concerns and their own lack of motivation to postpone childbearing are least likely to use hormonal contraceptives after delivery and most likely to conceive again . Our findings suggest that future research should focus on the development of more effective interventions for preventing repeat conceptions among adolescent mothers who had the capacity to prevent their first pregnancies Objective To compare the incidence of repeat pregnancy and method continuation rate at 12 months postpartum in young women who chose either depot medroxyprogesterone acetate or oral contraceptives ( OCs ) as contraception . Methods We conducted a prospect i ve cohort study of 122 postpartum women younger than 18 years of age who delivered between January 8 , 1997 and December 31 , 1997 . Patients choosing depot medroxyprogesterone acetate ( n = 76 ) and OCs ( n = 46 ) were accrued for 12 months and were followed-up for a minimum of 12 months . Main outcome measures were median contraceptive method continuation and the incidence of repeat pregnancy at 12 months postpartum . Results There was no difference in mean age at delivery ( P = .47 ) , parity ( P = .84 ) , or gravidity ( P = .78 ) between depot medroxyprogesterone acetate and OC users . At 12 months postpartum , 27.4 % of OC users and 55.3 % of depot medroxyprogesterone acetate users were still using contraception . Median time to contraceptive discontinuation was longer for those choosing depot medroxyprogesterone acetate compared with OCs ( 17.8 vs 7.4 months , respectively , P = .002 ) . The overall incidence of repeat pregnancy at 12 months postpartum was 10.6 % . Among OC and depot medroxyprogesterone acetate users , respectively , 24 % and 2.6 % became pregnant again , producing a relative risk ( RR ) of 9.09 ( 95 % confidence interval [ CI ] 2.1 , 39.2 ) for repeat pregnancy among OC users . The mean time to repeat pregnancy ( this was reported instead of the median time whenever the pregnancy rate had not reached 50 % at the end of the follow-up period ) was longer for depot medroxyprogesterone acetate compared with OC users ( 17.1 months vs 13.2 months , respectively , P < .001 ) . Conclusion Adolescent mothers using depot medroxyprogesterone acetate injection for contraception have a higher method continuation rate and a lower incidence of repeat pregnancy at 12 months postpartum than those selecting OCs during the same period CONTEXT Women with multiple pregnancies in adolescence may experience medical , psychological and social complications . Improved underst and ing of the individual- , dyad- , family- , peer/community- and social system-level risk factors for repeat pregnancy may lead to the development of more effective prevention strategies for adolescent mothers in a variety of setting s. METHODS Between 1993 and 1996 , white , black and Mexican American adolescent mothers at a labor and delivery unit in Texas were interviewed after delivery and completed written surveys prospect ively for up to 48 months . Logistic regression analyses were used to determine predictors of repeat pregnancy within 24 months , using social ecological theory as a guide . RESULTS Forty-two percent of adolescent mothers experienced a repeat pregnancy within 24 months ; 73 % of these delivered a second child . Individual-level predictors were planning to have another baby within five years ( odds ratio , 1.6 ) and not using long-acting contraceptives within three months of delivery ( 2.4 ) . Dyad-level predictors were not being in a relationship with the father of the first child three months after delivery ( 2.0 ) , being more than three years younger than the first child 's father ( 1.6 ) and experiencing intimate partner violence within three months after delivery ( 1.9 ) . Peer/community-level predictors were not being in school three months postpartum ( 1.8 ) and having many friends who were adolescent parents ( 1.5 ) . CONCLUSION Adolescent mothers are at high risk for a rapid subsequent pregnancy . Interventions that address the complex and multifaceted aspects of the lives of adolescent mothers are needed to prevent repeat pregnancy CONTEXT . Rates of rapid second births among low-income black adolescent mothers range from 20 % to 50 % . Most efforts to prevent rapid second births have been unsuccessful . OBJECTIVES . There were 4 objectives : ( 1 ) to examine whether a home-based mentoring intervention was effective in preventing second births within 2 years of the adolescent mother 's first delivery ; ( 2 ) to examine whether greater intervention participation increased the likelihood of preventing a second birth ; ( 3 ) to examine whether second births were better predicted from a risk practice perspective or a family formation perspective , based on information collected at delivery ; and ( 4 ) to examine how risk practice s or family formation over the first 2 years of parenthood were related to a second birth . DESIGN . We conducted a r and omized , controlled trial of a home-based intervention curriculum , based on social cognitive theory , and focused on interpersonal negotiation skills , adolescent development , and parenting . The curriculum was delivered biweekly until the infant 's first birthday by college-educated , black , single mothers who served as mentors , presenting themselves as “ big sisters . ” The control group received usual care . Follow-up evaluations were conducted in the homes 6 , 13 , and 24 months after recruitment . METHODS . Participants were recruited from urban hospitals at delivery and were 181 first time , black adolescent mothers ( < 18 years of age ) ; 82 % ( 149 of 181 ) completed the 24-month evaluation . RESULTS . Intent-to-treat analyses revealed that control mothers were more likely than intervention mothers to have a second infant . The complier average causal effect was used to account for variability in intervention participation . Having ≥2 intervention visits increased the odds of not having a second infant more than threefold . Only 1 mother who completed ≥6 visits had a second infant . At delivery of their first infant , mothers who had a second infant were slightly older ( 16.7 vs 16.2 years ) and were more likely to have been arrested ( 30 % vs 14 % ) . There were no differences in baseline contraceptive use or other measures of risk or family formation . At 24 months , mothers who had a second infant reported high self-esteem , positive life events , and romantic involvement and residence with the first infant 's father . At 24 months , there were no differences in marital rates ( 2 % ) , risk practice s , or contraceptive use between mothers who did and did not have a second infant . Mothers who did not have a second infant were marginally more likely to report no plans for contraception in their next sexual contact compared with mothers who had a second infant ( 22 % vs 8 % , respectively ) . CONCLUSIONS . A home-based intervention founded on a mentorship model and targeted toward adolescent development , including negotiation skills , was effective in preventing rapid repeat births among low-income , black adolescent mothers . The effectiveness of the intervention could be seen after only 2 visits and increased over time . There were no second births among mothers who attended ≥8 sessions . There was no evidence that risk behavior or contraceptive use was related to rapid second births . There was some evidence that rapid second births among adolescent mothers were regarded as desirable and as part of a move toward increasing autonomy and family formation , thereby undermining intervention programs that focus on risk avoidance . Findings suggest the merits of a mentoring program for low-income , black adolescent mothers , based on a relatively brief ( 6–8 sessions ) curriculum targeted toward adolescent development and interpersonal negotiation skills OBJECTIVES To examine the determinants of pregnancy within 2 years of a teenager giving birth for the first time ( rapid-repeat pregnancy [ RRP ] ) and resumption of sexual intercourse after the birth . DESIGN , SETTING AND PARTICIPANTS Prospect i ve cohort study between June 2004 and September 2006 at the sole tertiary obstetric hospital in Western Australia involving teenagers who gave birth for the first time . Data were collected using question naires at recruitment , 6 weeks and 3-monthly intervals for up to 2 years postpartum . MAIN OUTCOME MEASURES RRP and time to a return to sexual intercourse after giving birth . RESULTS Of the 147 participants , 49 ( 33 % ) experienced an RRP . Sexual intercourse was independently significantly associated with using an oral contraceptive  ( odds ratio [ OR ] , 2.83 ; 95 % CI , 1.38 - 5.82 ) ; living with the birth father ( OR , 8.43 ; 95 % CI , 5.12 - 13.86 ) ; intending to become pregnant ( OR , 3.20 ; 95 % CI , 1.53 - 6.65 ) ; smoking marijuana ( OR , 2.60 ; 95 % CI , 1.38 - 4.79 ) ; and using alcohol ( OR , 1.93 ; 95 % CI , 1.17 - 3.20 ) . Use of long-acting contraceptives was associated with reduced odds of RRP ( OR , 0.27 ; 95 % CI , 0.12 - 0.62 ) , while teenagers who used an oral contraceptive had a similar risk of RRP compared with those using barrier methods or no contraception . Other factors predicting RRP were : being sexually active for more than 3 months ( OR , 8.96 ; 95 % CI , 1.97 - 40.74 ) ; intending to become pregnant ( OR , 2.39 ; 95 % CI , 1.62 - 4.93 ) ; and being an Indigenous Australian ( OR , 2.38 ; 95 % CI , 1.38 - 4.11 ) . CONCLUSION There are two options available to health care providers for reducing the rate of RRP : to facilitate teenage mothers ' access to long-acting contraceptives ; and to gain clear underst and ing of their intention with regard to repeat pregnancy and to provide appropriate support STUDY OBJECTIVE Accumulating evidence suggests that parental monitoring is associated with adolescents '  sexual risk behaviors . However , evidence associating low parental monitoring with greater odds of becoming pregnant has not been reported . The objective of this study was to prospect ively assess the relationship of low perceived parental monitoring with incidence of biologically confirmed pregnancy among a sample of low-income African-American adolescent females . DESIGN A prospect i ve study . SETTING AND PARTICIPANTS African-American females 14 - 18 years of age were recruited from schools and health clinics in low-income neighborhoods . Adolescents completed an in-depth survey and interview at baseline and 6 months later . The study achieved an 85.7 % baseline participation rate ( n = 522 ) and 92 % ( n = 482 ) returned at follow-up . Only adolescents who initially tested negative for pregnancy were included in the analysis ( n = 410 ) . MAIN OUTCOME MEASURES Incidence of biologically assessed pregnancy . RESULTS In controlled analyses , among adolescents testing negative for pregnancy at baseline , those who reported less parental  monitoring  were 2.5 times more likely to become pregnant in the 6-month follow-up period ( AOR = 2.50 , 95 % CI = 1.1 - 5.9 , P < .04 ) . CONCLUSION Low parental monitoring was prospect ively associated with incidence of biologically confirmed pregnancy among minority adolescent females . This finding adds to a growing body of empirical literature that supports the value of parental monitoring as a protective factor in adolescents ' lives . Interventions design ed to increase parental monitoring or adolescent females ' perceptions of their parents ' monitoring may be effective components of pregnancy prevention programs design ed for minority youth BACKGROUND While literacy is a key factor in health across the life course , the association of literacy and teenage childbearing has not been assessed in the US . STUDY DESIGN Prospect i ve cohort study using st and ardized reading data from 12,339 girls in the seventh grade in the 1996 - 97 or 1997 - 98 academic years of the Philadelphia Public School System linked to birth records from the city of Philadelphia ( 1996 - 2002 ) . RESULTS Less than average reading skill was independently associated with two and a half times the risk of teen childbearing than average reading skill ( aHR 2.51 , 95 % CI : 1.67 - 3.77 ) . Above average reading skill was associated with less risk ( aHR 0.27 , 95 % CI 0.17 - 0.44 ) . A significant interaction ( p<.05 ) between reading skill and race/ethnicity indicated that Hispanic and African American girls had greater risk of teen-childbearing by literacy . CONCLUSIONS Literacy strongly predicts risk of teenage childbearing independent of confounders . The effects of literacy were stronger among girls with Hispanic or African American race/ethnicity
OBJECTIVE : Existing evidence of predictors of  repeated teenage pregnancy  has not been assessed rigorously .
This systematic review provides a comprehensive evaluation of protective and risk factors that are associated with  repeated teenage pregnancy  through a metaanalytical consensus .