Clinical Edge

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Contraception Initiation Among Women in the US

Pediatrics; ePub 2019 Jan 15; Murray Horwitz, et al

Delayed contraceptive initiation is more common among African American, Hispanic, and low-income women and is strongly associated with short-term risk of unwanted pregnancy, according to a recent study. Therefore, pediatricians play a key role in making timely contraception available to adolescents at or before sexual debut. Researchers used nationally representative cross-sectional data from 4 cycles of the National Survey of Family Growth, 2002–2015. They calculated outcomes from self-reported dates of sexual debut, contraceptive initiation, and unwanted pregnancy and then compared trends in timely contraceptive initiation (within 1 month of sexual debut) by method and by race and/or ethnicity and income. Finally, they compared the risk of unwanted pregnancy for delayed vs timely contraceptive initiation. They found:

  • Responses from 26,359 women with sexual debuts in 1970–2014 were analyzed.
  • 1 in 5 overall and 1 in 4 African American, Hispanic, or low-income respondents reported delayed contraceptive initiation, which was associated with unwanted pregnancy within 3 months of sexual debut (adjusted risk ratio 3.7 vs timely contraceptive initiation).
  • Timely contraceptive initiation with less effective vs effective methods was not associated with unwanted pregnancy within 3 months.

Murray Horwitz ME, Ross-Degnan D, Pace LE. Contraceptive initiation among women in the United States: Timing, methods used, and pregnancy outcomes. [Published online ahead of print January 15, 2019]. Pediatrics. doi:10.1542/peds.2018-2463.

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