Half of all pregnancies worldwide are unintended, and the rate is even higher in women aged ≤25 years. We sought to identify which contraception method was the most effective option to prevent unintended pregnancy in young women and adolescents.
Without language restrictions, systematic searches were carried out of the PubMed, Embase, Lilacs, and Cochrane databases. Abstracts and full-text articles of observational studies and randomized controlled trials comparing the use of multiple methods of LARC and SARC in young women and adolescents were screened and reviewed. RRs and mean differences with their 95% CI were derived using a random-effects meta-analytical model. Meta-analyses provided pooled estimates for adverse events, continuation rates, and efficacy of LARC methods in young women and adolescents. Nine of the 25 included studies compared LARC with SARC, and 16 compared LARC methods only.
At 12 months, young women had better adherence to LARC than SARC, suggesting a better-unintended pregnancy prevention outcome for young women. However, more young women chose SARC. Pregnancy during LARC use was rare.
The study concluded that LARC methods are the most efficacious in preventing pregnancy, and women should be informed of this if pregnancy prevention is their priority. The evidence, however, is of low quality.