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Meta-Analysis
. 2002 Jun 15;324(7351):1426.
doi: 10.1136/bmj.324.7351.1426.

Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials

Alba DiCenso  1 , Gordon Guyatt, A Willan, L Griffith
Affiliations
Meta-Analysis

Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials

Alba DiCenso et al. BMJ. .

Abstract

Objective: To review the effectiveness of primary prevention strategies aimed at delaying sexual intercourse, improving use of birth control, and reducing incidence of unintended pregnancy in adolescents.

Data sources: 12 electronic bibliographic databases, 10 key journals, citations of relevant articles, and contact with authors.

Study selection: 26 trials described in 22 published and unpublished reports that randomised adolescents to an intervention or a control group (alternate intervention or nothing).

Data extraction: Two independent reviewers assessed methodological quality and abstracted data.

Data synthesis: The interventions did not delay initiation of sexual intercourse in young women (pooled odds ratio 1.12; 95% confidence interval 0.96 to 1.30) or young men (0.99; 0.84 to 1.16); did not improve use of birth control by young women at every intercourse (0.95; 0.69 to 1.30) or at last intercourse (1.05; 0.50 to 2.19) or by young men at every intercourse (0.90; 0.70 to 1.16) or at last intercourse (1.25; 0.99 to 1.59); and did not reduce pregnancy rates in young women (1.04; 0.78 to 1.40). Four abstinence programmes and one school based sex education programme were associated with an increase in number of pregnancies among partners of young male participants (1.54; 1.03 to 2.29). There were significantly fewer pregnancies in young women who received a multifaceted programme (0.41; 0.20 to 0.83), though baseline differences in this study favoured the intervention.

Conclusions: Primary prevention strategies evaluated to date do not delay the initiation of sexual intercourse, improve use of birth control among young men and women, or reduce the number of pregnancies in young women.

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Figures

Figure 1
Figure 1
Effect of interventions on whether adolescents started to have sexual intercourse
Figure 2
Figure 2
Effect of interventions on whether adolescents always used birth control
Figure 3
Figure 3
Effect of interventions on whether adolescents used birth control the last time they had sexual intercourse
Figure 4
Figure 4
Effect of interventions on rates of pregnancy in adolescent women
Figure 5
Figure 5
Effect of interventions on rates of pregnancy in partners of young men
See this image and copyright information in PMC

Comment in

References

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    1. Brown SS, Eisenberg L, editors. The best intentions: unintended pregnancy and the well-being of children and families. Washington, DC: National Academy Press; 1995. - PubMed
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    1. Geronimus AT, Korenman S. The socioeconomic consequences of teen childbearing reconsidered. Q J Economics. 1992;107:1187–1214.
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