Sexual and reproductive health in pregnant teenagers presenting for antenatal care or for termination

      Summary

      Sexual health is an important public health issue with attention being paid to the development of national policy strategies for teenage pregnancy and reproductive health. A substantial proportion of pregnant adolescents engage in unprotected intercourse and risky sexual behaviours that may increase their risk for acquiring sexually transmitted infections (STIs) during pregnancy and beyond. Pregnant teenagers are also at high risk of subsequent teenage conceptions, with approximately one fifth of teenage pregnancies being to a teenager who has conceived previously. This review not only examines the sexual and reproductive health of pregnant teenagers presenting for antenatal care or for termination of pregnancy, but also outlines the value of promoting safe sex behaviours whilst still pregnant, followed by promotion of dual protection after termination or postpartum.

      Keywords

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      References

        • McLeod A.
        Changing patterns of teenage pregnancy: population based study of small areas.
        Br Med J. 2001; 323: 199-203
        • Chevalier A.
        • Viitanen T.K.
        The long-run labour market consequences of teenage motherhood in Britain.
        London School of Economics and Political Science, London2001 (p. 35)
      1. Social Exclusion Unit. Teenage pregnancy; 1999 (Report cm 4342).

      2. Teenage Pregnancy Unit. Statistics—national and local authority conception statistics. http://www.dfes.gov.uk/teenagepregnancy/dsp_content.cfm?pageid=245 accessed 14/12/05; 2004.

        • Meade C.
        • Ickovics J.
        Systematic review of sexual risk among pregnant and mothering teens in the USA: pregnancy as an opportunity for integrated prevention of STD and repeat pregnancy.
        Soc Sci Med. 2005; 60: 661-678
        • Wellings K.
        • Nanchahal K.
        • Macdowall W.
        • McManus S.
        • Erens B.
        • Mercer C.
        • et al.
        Sexual behaviour in Britain: early heterosexual experience.
        Lancet. 2001; 358: 1843-1850
      3. The UK Collaborative Group for HIV and STI Surveillance. Mapping the issues: HIV and other sexually transmitted infections in the United Kingdom: 2005: Health Protection Agency, 2005.

      4. Office of National Statistics. New episodes of genital chlamydia: by sex and age, 1995–2001: Social Trends 33, 2001.

      5. Office of National Statistics. New episodes of gonorrhoea: by gender and age, 1995–2000: Social Trends 32; 2001.

      6. Office of National Statistics. Population Trends 121: HMSO; 2005.

        • Pimenta J.
        • Catchpole M.
        • Rogers P.
        • Hopwood J.
        • Randall S.
        • Mallinson H.
        • et al.
        Opportunistic screening for genital chlamydial infection. II: Prevalence among healthcare attenders, outcome, and evaluation of positive cases.
        Sex Transm Dis. 2003; 79: 22-27
        • Macmillan S.
        • Walker R.
        • LOloto E.
        • Ftzmaurice A.
        • Templeton A.
        Ignorance about chlamydia among sexually active women — a two centre study.
        Hum Reprod. 1999; 14: 1131-1135
        • Wilson T.E.
        • Minkoff H.
        • McCalla S.
        • Petterkin C.
        • Jaccard J.
        The relationship between pregnancy and sexual risk taking.
        Am J Obstet Gynecol. 1996; 174: 1033-1036
        • Shlay J.C.
        • Mayhugh B.
        • Foster M.
        • Maravi M.E.
        Predicting pregnancy risk in women attending an STD clinic.
        Sex Transm Dis. 2001; 29: 491-496
        • Niccolai L.M.
        • Ethier K.A.
        • Kershaw T.S.
        • Lewis J.B.
        • Ickovics J.R.
        Pregnant adolescents at risk: sexual behaviours and sexually transmitted disease prevalence.
        Am J Obstet Gynecol. 2003; 188: 63-70
        • Koniak-Griffin D.
        • Brecht M- L.
        AIDS risk behaviors, knowledge, and attitudes among pregnant adolescents and young mothers.
        Health Educ Behav. 1997; 24: 613-624
        • Ickovics J.
        • Niccolai L.
        • Lewis J.
        • Kershaw T.
        • Ethier K.
        High postpartum rates of sexually transmitted infections among teens: pregnancy as a window of opportunity for prevention.
        Sex Transm Infect. 2003; 79: 469-473
        • Birch D.M.L.
        The adolescent parent — a fifteen year longitudinal study of school age mothers and their children.
        J Adolescent Health Welf. 1997; 10: 17-25
        • Churchill D.
        • Allen J.
        • Pringle M.
        • Hippisley-Cox J.
        • Ebdon D.
        • Macpherson M.
        • et al.
        Consultation patterns and provision of contraception in general practice before teenage pregnancy: case–control study.
        Br Med J. 2000; 321: 486-489
        • Curtis H.A.
        • Lawrence C.J.
        • Tripp J.H.
        Teenage sexual intercourse and pregnancy.
        Arch Dis Child. 1988; 63: 373-379
        • Smith G.C.S.
        • Pell J.P.
        Teenage pregnancy and risk of adverse perinatal outcomes associated with first and second births: population based retrospective cohort study.
        Br Med J. 2001; 323: 476-479
      7. Office for National Statistics. Abortion statistics: legal abortions carried out under the 1967 Abortion Act in England and Wales, 2001: Tables 5 and 17.

      8. Office for National Statistics. Abortion statistics: legal abortions carried out under the 1967 Abortion Act in England and Wales, 1991:Tables 1, 6 and 22.

        • Counterpoint Research
        Young people's perceptions of contraception and seeking contraception advice.
        Department of Health, London2001
        • DiCenso A.
        • Guyatt G.
        • Willan A.
        • Griffith L.
        Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials.
        Br Med J. 2002; 324: 1426-1435
        • Pinkerton S.
        A relative risk-based, disease-specific definition of sexual abstinence failure rates.
        Health Educ Behav. 2001; 28: 10-20
        • Thomas M.
        Abstinence-based programs for prevention of adolescent pregnancies. A review.
        J Adolescent Health. 2000; 26: 5-17
        • Lieberman L.
        • Gray H.
        • Wier M.
        • Fiorentino R.
        • Maloney P.
        Long-term outcomes of an abstinence-based, small-group pregnancy prevention program in New York City schools.
        Fam Plann Perspect. 2000; 32: 237-245
      9. World Health Organisation. Selected practice recommendations for contraceptive use, 2002. p. 8 [Table 1].

      10. International Planned Parenthood Federation. Statement on dual protection against unwanted pregnancy and sexually transmitted infections, including HIV. http://content.ippf.org/output/ORG/files/6555.pdf, 2000.

      11. World Health Organisation. Integrating STI management into family planning services: what are the benefits? WHO/RHR/99.10, 1999.

        • Roth C.
        • Feldman R.
        • Lees S.
        Antenatal HIV testing: a study of midwives’ views and experiences.
        Dept. of Midwifery, City University, London2001
        • Jolley S.
        Promoting teenage sexual health: an investigation into the knowledge, activities and perceptions of gynecology nurses.
        J Adv Nurs. 2001; 36: 246-255
        • Beddard D.
        • Chandiok S.
        • James P.
        • Russell A.
        A 6-month pilot of a collaborative clinic between genitourinary medicine services and a young persons’ sexual health clinic.
        J Fam Plan Reprod Health Care. 2003; 29: 40-42
      12. Swann C, Bowe K, GM, Kosmin M. Teenage pregnancy and parenthood: a review of reviews. Evidence briefing: NHS Health Development Agency, 2003.

        • Olds D.
        • Robinson J.
        • O’Brien R.
        • Luckey D.
        • Pettitt L.
        • Henderson C.
        • et al.
        Home visiting by paraprofessionals and by nurses: a randomized controlled trial.
        Pediatrics. 2002; 110: 486-495
        • Stevens-Simon C.
        • Kelly L.
        • Kulick R.
        A village would be nice but it takes a long-acting contraceptive to prevent repeat adolescent pregnancies.
        Am J Prevent Med. 2001; 21: 60-65
        • Kitzman H.
        • Olds D.L.
        • Henderson C.R.
        • Hanks C.
        • Cole R.
        • Tatelbaum R.
        • et al.
        Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing: a randomized controlled trial.
        J Am Med Assoc. 1997; 278: 644-652