Unintended pregnancy in adolescents: analysis of 10 years
ESC Congress Library. Sousa A. 05/11/18; 208252; ESC286
Ana Filipa Sousa
Ana Filipa Sousa
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Introduction: In Portugal, adolescents are a priority group in reproductive health policies. Sexual education is mandatory at school, the access to Family Planning has been promoted, and since 2007 the abortion is legal until 10 weeks. Between adolescents the use of contraception has increased, the abortions have decreased and the number of adolescents who became mothers each year has also decreased but it remains a problem. Objective: Analyse the general characteristics and contraception use of the adolescents who did an abortion between 2007 and 2016, on our Service. Design and methods: Retrospective and descriptive analysis of the clinical records of adolescents. Statistic analysis made with IBM SPSS-Statistics® 21.0. Results: We included 288 adolescents, mean age 17.6±1.4 years [13-19]. They were mainly Portuguese (91.7%, 264). The majority was single (88.5%, 155), and 22.9% (66) were living with their boyfriend. 81.6% (235) were students. Additionally, 4.9% (13) had already had children and 4.8% (14) had had an abortion before. In the year before the abortion, 81.1% (232) had attended to a Family Planning appointment. The majority (74.0%, 213) were users of a contraceptive method. From those, 63.4% (135) were using condom, 36.1% (77) oral contraceptive and 0.5% (n=1) vaginal ring. The main reasons for an unplanned pregnancy were unprotected sexual relations (49.0% 141), followed by irregular use of the contraceptive method (17.0% 49, 9.4% 27, respectively), failure of the method (16.0% 46), pharmacologic interactions (2.4% 7), rupture of the condom (1.7% 5). Emergency contraception was used only by 3.1% (9). The mean gestational age was 50 [35-76] days. After abortion, 96.2% (277) chose to use contraception. The favorite method was oral contraceptives (65.3%, 181), followed by Implant 26.5% (63) and by intrauterine system 3.6% (10). Conclusions: The adolescents who requested for abortion attended for a Family Planning appointment in the year before abortion and most of them were using contraception. The compliance to contraception was determinant for the unplanned pregnancies and abortion.  The Family Planning providers must improve the use of effective contraception and the use of emergency contraception. The abortion was a well-accepted opportunity to improve the use of Long Acting Reversible Contraceptives, mainly implants.
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