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Contemporary intrauterine contraception use among adolescents: Examination of a national health claims database

Abbey Berenson, The University of Texas Medical Branch, 2010
See also executive summary and publication in Obstetrics and Gynecology.

Project abstract

The United States has the highest rate in the world of unintended pregnancy among teenagers. To combat this problem, effective methods of long-term, reversible birth control must be made available to this vulnerable population.

One method which is highly effective in teenagers, as it does not require daily compliance, is intrauterine contraception (IUC). However, few US physicians will prescribe IUC to adolescents even though its use in women <20 years of age is now classified as Category 2 (generally use, benefits outweigh risks) by the World Health Organization. In fact, a recent survey of obstetricians/gynecologists found that only 19% would offer IUC to an unmarried 17-year-old who had never been pregnant. It appears that this hesitation is due to concerns about the risk of pelvic inflammatory disease which was associated with earlier versions.

Unfortunately, there are almost no studies on the two currently available IUCs conducted on teenagers to address this concern. Data are also limited on young adults 20-24 years of age.

To address this critical need, we will use a claims database containing information on approximately 100,000 women with IUC insertions between 2001 and 2009 to examine prescription patterns and complications among women aged 15-19 years as compared to those 20-24 and 25-44 years.

If complications do not differ by age, as we hypothesize, these data will reassure physicians of the safety of IUC use in teenagers and young adults. Moreover, we will conduct analysis by IUC type (ParaGard vs. Mirena) which will allow us to determine which is better tolerated by adolescents. Overall, this study will provide much-needed data on use of this highly effective method among young women at risk of unintended pregnancy.

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