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Background Although levonorgestrel implants (Norplant) would appear to be a good contraceptive option for adolescent mothers, there is little information about the use of Norplant in this population.
Methods We studied 100 postpartum adolescents who chose a contraceptive method at an urban teaching hospital between September 1991 and July 1992. Structured interviews were conducted and medical records were reviewed soon after delivery and at a mean (±SD) of 15.5 ±2.9 months post partum.
Results Forty-eight of the adolescent mothers chose Norplant, 50 chose oral contraceptives, and 2 (not further studied) chose barrier methods of contraception. The factors significantly associated with the choice of Norplant were older age (16.7 years among those who chose Norplant, vs. 16.2 years among those who chose oral contraceptives), multiparity (24 subjects vs. 6 subjects), and previous use of oral contraceptives (34 subjects vs. 21 subjects). During follow-up, there were no differences between the Norplant group and the oral-contraceptive group in the frequency of clinic visits (an average of 2.3 visits per subject in each group), failure to return after the postpartum visit (9 subjects vs. 11 subjects), or the incidence of sexually transmitted diseases (42 percent vs. 36 percent). At follow-up, 95 percent of the subjects in the Norplant group and 33 percent of those in the oral-contraceptive group were still using the method they had chosen (P<0.001). During the first postpartum year 1 subject in the Norplant group and 19 in the oral-contraceptive group became pregnant (P<0.001). Norplant users did not differ from all other adolescents studied with regard to sexual activity or condom use.
Conclusions The selection of Norplant by adolescent mothers as a method of contraception is associated with higher rates of continued use and lower rates of new pregnancy than the selection of oral contraceptives and does not affect the use of health care services, sexual activity, condom use, or the rate of sexually transmitted diseases.
Source Information
From the Division of Women's Health, Department of Obstetrics and Gynecology, New York Hospital-Cornell Medical Center, New York (M.P.); the Division of General Internal Medicine, Department of Medicine (G.S., C.F.), and the Department of Obstetrics and Gynecology (S.S.), University of Pennsylvania School of Medicine, Philadelphia; and Queens University, Kingston, Ont., Canada (A.R.). Presented in part at meetings of the Association for Reproductive Health Professionals, Los Angeles, November 5-6, 1993, and the Society for Adolescent Medicine, Chicago, March 18-21, 1993.
Address reprint requests to Dr. Polaneczky at Box 392, Department of Obstetrics and Gynecology, New York Hospital-Cornell Medical Center, 525 E. 68th St., New York, NY 10021.
Related Letters:
Norplant
Shihata A. A., Salzetti R. G., Lewy R. I., Polaneczky M., Sondheimer S., Slap G. B.
Extract |
Full Text
N Engl J Med 1995;
332:821-822, Mar 23, 1995.
Correspondence
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