Preconception and Interconception Pediatric Primary Care Utilization of Pregnant and Parenting Teens
Gaps in preventive care may contribute to adverse outcomes among pregnant teens. This study quantified teen preventive care utilization before and after pregnancy. A continuous retrospective cohort identified 150 teens with a positive pregnancy test (July 2015 to May 2017) at two pediatric primary c...
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| Veröffentlicht in: | Journal of adolescent health 2021-08, Vol.69 (2), p.315-320 |
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| creator | Gregory, Emily F. Henry, Drisana Akers, Aletha Y. |
| description | Gaps in preventive care may contribute to adverse outcomes among pregnant teens. This study quantified teen preventive care utilization before and after pregnancy.
A continuous retrospective cohort identified 150 teens with a positive pregnancy test (July 2015 to May 2017) at two pediatric primary care sites. Chart review assessed office visits for 18 months before and after the pregnancy test. We also assessed contraceptive counseling, pregnancy outcomes (live birth, miscarriage, termination), and continuity with a single clinician. Demographic factors included age, race, ethnicity, primary insurance, and residential zip code. Logistic regression identified factors associated with visits after pregnancy. Separately, for a cohort of 47 parenting teens who received primary care at the same site as their infants, we assessed teen–infant care after birth.
Teens were predominantly non-Latina black (91%) and Medicaid insured (71%). Before pregnancy, most teens had preventive visits (66%) and reported contraceptive use (65%). After pregnancy, 52% discussed pregnancy decisions within a month, 55% reported contraceptive use, and 64% had any primary care visit. Postpregnancy visits were associated with teen age ( |
| doi_str_mv | 10.1016/j.jadohealth.2020.12.132 |
| format | Article |
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A continuous retrospective cohort identified 150 teens with a positive pregnancy test (July 2015 to May 2017) at two pediatric primary care sites. Chart review assessed office visits for 18 months before and after the pregnancy test. We also assessed contraceptive counseling, pregnancy outcomes (live birth, miscarriage, termination), and continuity with a single clinician. Demographic factors included age, race, ethnicity, primary insurance, and residential zip code. Logistic regression identified factors associated with visits after pregnancy. Separately, for a cohort of 47 parenting teens who received primary care at the same site as their infants, we assessed teen–infant care after birth.
Teens were predominantly non-Latina black (91%) and Medicaid insured (71%). Before pregnancy, most teens had preventive visits (66%) and reported contraceptive use (65%). After pregnancy, 52% discussed pregnancy decisions within a month, 55% reported contraceptive use, and 64% had any primary care visit. Postpregnancy visits were associated with teen age (<18 vs. ≥18 years odds ratio 2.84, 95% confidence interval 1.17–6.90) and pregnancy outcome (termination vs. live birth odds ratio 4.02, 95% confidence interval 1.47–11.01). Among parenting teens, there were more infant visits than teen visits, and continuity was higher for infants.
In a primary care cohort of pregnant teens, gaps persisted in pediatric clinical follow-up after pregnancy. Particularly in situations where pregnancy led to a birth, pregnancy frequently prompted a transition away from pediatric care.</description><identifier>ISSN: 1054-139X</identifier><identifier>EISSN: 1879-1972</identifier><identifier>DOI: 10.1016/j.jadohealth.2020.12.132</identifier><identifier>PMID: 33483235</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abortion ; Adolescent transitions ; Chart reviews ; Child care ; Childbirth & labor ; Confidence intervals ; Contraceptives ; Demography ; Ethnicity ; Infants ; Insurance ; Interconception care ; Medicaid ; Miscarriage ; Parenting ; Parents & parenting ; Preconception care ; Pregnancy ; Preventive care ; Preventive medicine ; Primary care ; Race ; Teen pregnancy ; Teenage pregnancy ; Teenagers ; Teens ; Termination ; Visits</subject><ispartof>Journal of adolescent health, 2021-08, Vol.69 (2), p.315-320</ispartof><rights>2020 Society for Adolescent Health and Medicine</rights><rights>Copyright © 2020. Published by Elsevier Inc.</rights><rights>Copyright Elsevier BV Aug 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c402t-d162f3685b0158581619e4775572533740c755da841d736253d7dfa34a9154063</citedby><cites>FETCH-LOGICAL-c402t-d162f3685b0158581619e4775572533740c755da841d736253d7dfa34a9154063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1054139X2030851X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,30976,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33483235$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gregory, Emily F.</creatorcontrib><creatorcontrib>Henry, Drisana</creatorcontrib><creatorcontrib>Akers, Aletha Y.</creatorcontrib><title>Preconception and Interconception Pediatric Primary Care Utilization of Pregnant and Parenting Teens</title><title>Journal of adolescent health</title><addtitle>J Adolesc Health</addtitle><description>Gaps in preventive care may contribute to adverse outcomes among pregnant teens. This study quantified teen preventive care utilization before and after pregnancy.
A continuous retrospective cohort identified 150 teens with a positive pregnancy test (July 2015 to May 2017) at two pediatric primary care sites. Chart review assessed office visits for 18 months before and after the pregnancy test. We also assessed contraceptive counseling, pregnancy outcomes (live birth, miscarriage, termination), and continuity with a single clinician. Demographic factors included age, race, ethnicity, primary insurance, and residential zip code. Logistic regression identified factors associated with visits after pregnancy. Separately, for a cohort of 47 parenting teens who received primary care at the same site as their infants, we assessed teen–infant care after birth.
Teens were predominantly non-Latina black (91%) and Medicaid insured (71%). Before pregnancy, most teens had preventive visits (66%) and reported contraceptive use (65%). After pregnancy, 52% discussed pregnancy decisions within a month, 55% reported contraceptive use, and 64% had any primary care visit. Postpregnancy visits were associated with teen age (<18 vs. ≥18 years odds ratio 2.84, 95% confidence interval 1.17–6.90) and pregnancy outcome (termination vs. live birth odds ratio 4.02, 95% confidence interval 1.47–11.01). Among parenting teens, there were more infant visits than teen visits, and continuity was higher for infants.
In a primary care cohort of pregnant teens, gaps persisted in pediatric clinical follow-up after pregnancy. Particularly in situations where pregnancy led to a birth, pregnancy frequently prompted a transition away from pediatric care.</description><subject>Abortion</subject><subject>Adolescent transitions</subject><subject>Chart reviews</subject><subject>Child care</subject><subject>Childbirth & labor</subject><subject>Confidence intervals</subject><subject>Contraceptives</subject><subject>Demography</subject><subject>Ethnicity</subject><subject>Infants</subject><subject>Insurance</subject><subject>Interconception care</subject><subject>Medicaid</subject><subject>Miscarriage</subject><subject>Parenting</subject><subject>Parents & parenting</subject><subject>Preconception care</subject><subject>Pregnancy</subject><subject>Preventive care</subject><subject>Preventive medicine</subject><subject>Primary care</subject><subject>Race</subject><subject>Teen pregnancy</subject><subject>Teenage pregnancy</subject><subject>Teenagers</subject><subject>Teens</subject><subject>Termination</subject><subject>Visits</subject><issn>1054-139X</issn><issn>1879-1972</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqFkU1rGzEQhkVoyVfzF8JCL72sq-_VHlOTJoZAfLChNyGvZm0ta8mR5ELz66vESRpy6UnD6HlnhvdFqCJ4QjCR34fJYGzYgBnzZkIxLW06IYweoVOimrYmbUM_lRoLXhPW_jpBZykNuEglwcfohDGuGGXiFNl5hC74DnbZBV8Zb6uZzxDf9eZgncnRddU8uq2Jf6qpiVAtsxvdo3lGQl_-YO2Nz88j5gXw2fl1tQDw6Qv63JsxwcXLe46WP68X09v67v5mNr26qzuOaa4tkbRnUokVJkIJRSRpgTeNEA0VjDUcd6W2RnFiGyZLzza2N4yblgiOJTtH3w5zdzE87CFlvXWpg3E0HsI-acoVplJQoQr69QM6hH305TpNhZCYtpS3hVIHqoshpQi93h0s0ATrpyT0oP8loZ-S0ITqkkSRXr4s2K-2YN-Er9YX4McBgOLIbwdRp85Bcd26EknWNrj_b_kLjHadbQ</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Gregory, Emily F.</creator><creator>Henry, Drisana</creator><creator>Akers, Aletha Y.</creator><general>Elsevier Inc</general><general>Elsevier BV</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TS</scope><scope>7X8</scope></search><sort><creationdate>20210801</creationdate><title>Preconception and Interconception Pediatric Primary Care Utilization of Pregnant and Parenting Teens</title><author>Gregory, Emily F. ; Henry, Drisana ; Akers, Aletha Y.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c402t-d162f3685b0158581619e4775572533740c755da841d736253d7dfa34a9154063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abortion</topic><topic>Adolescent transitions</topic><topic>Chart reviews</topic><topic>Child care</topic><topic>Childbirth & labor</topic><topic>Confidence intervals</topic><topic>Contraceptives</topic><topic>Demography</topic><topic>Ethnicity</topic><topic>Infants</topic><topic>Insurance</topic><topic>Interconception care</topic><topic>Medicaid</topic><topic>Miscarriage</topic><topic>Parenting</topic><topic>Parents & parenting</topic><topic>Preconception care</topic><topic>Pregnancy</topic><topic>Preventive care</topic><topic>Preventive medicine</topic><topic>Primary care</topic><topic>Race</topic><topic>Teen pregnancy</topic><topic>Teenage pregnancy</topic><topic>Teenagers</topic><topic>Teens</topic><topic>Termination</topic><topic>Visits</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gregory, Emily F.</creatorcontrib><creatorcontrib>Henry, Drisana</creatorcontrib><creatorcontrib>Akers, Aletha Y.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Physical Education Index</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of adolescent health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gregory, Emily F.</au><au>Henry, Drisana</au><au>Akers, Aletha Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preconception and Interconception Pediatric Primary Care Utilization of Pregnant and Parenting Teens</atitle><jtitle>Journal of adolescent health</jtitle><addtitle>J Adolesc Health</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>69</volume><issue>2</issue><spage>315</spage><epage>320</epage><pages>315-320</pages><issn>1054-139X</issn><eissn>1879-1972</eissn><abstract>Gaps in preventive care may contribute to adverse outcomes among pregnant teens. This study quantified teen preventive care utilization before and after pregnancy.
A continuous retrospective cohort identified 150 teens with a positive pregnancy test (July 2015 to May 2017) at two pediatric primary care sites. Chart review assessed office visits for 18 months before and after the pregnancy test. We also assessed contraceptive counseling, pregnancy outcomes (live birth, miscarriage, termination), and continuity with a single clinician. Demographic factors included age, race, ethnicity, primary insurance, and residential zip code. Logistic regression identified factors associated with visits after pregnancy. Separately, for a cohort of 47 parenting teens who received primary care at the same site as their infants, we assessed teen–infant care after birth.
Teens were predominantly non-Latina black (91%) and Medicaid insured (71%). Before pregnancy, most teens had preventive visits (66%) and reported contraceptive use (65%). After pregnancy, 52% discussed pregnancy decisions within a month, 55% reported contraceptive use, and 64% had any primary care visit. Postpregnancy visits were associated with teen age (<18 vs. ≥18 years odds ratio 2.84, 95% confidence interval 1.17–6.90) and pregnancy outcome (termination vs. live birth odds ratio 4.02, 95% confidence interval 1.47–11.01). Among parenting teens, there were more infant visits than teen visits, and continuity was higher for infants.
In a primary care cohort of pregnant teens, gaps persisted in pediatric clinical follow-up after pregnancy. Particularly in situations where pregnancy led to a birth, pregnancy frequently prompted a transition away from pediatric care.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33483235</pmid><doi>10.1016/j.jadohealth.2020.12.132</doi><tpages>6</tpages></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Elsevier ScienceDirect Journals |
| subjects | Abortion Adolescent transitions Chart reviews Child care Childbirth & labor Confidence intervals Contraceptives Demography Ethnicity Infants Insurance Interconception care Medicaid Miscarriage Parenting Parents & parenting Preconception care Pregnancy Preventive care Preventive medicine Primary care Race Teen pregnancy Teenage pregnancy Teenagers Teens Termination Visits |
| title | Preconception and Interconception Pediatric Primary Care Utilization of Pregnant and Parenting Teens |
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