To determine the association of postpartum contraceptive use with repeat deliveries among adolescents and youth.
Retrospective, observational analysis of electronic health record data.
Single, urban facility in Denver, Colorado, USA.
Women aged 10 – 24 who gave birth between January 1, 2011 and December 31, 2015.
Postpartum contraceptive use and time to subsequent delivery.
Among 4,068 women, 1,735 (43%) used postpartum contraception. In adjusted analyses, characteristics associated with contraceptive use included Hispanic ethnicity (RR 1.1, p = 0.03), incremental prenatal visits (RR 1.01, p = 0.047), and attendance at postpartum care (RR 1.60, p < 0.001). Long-acting reversible contraceptive (LARC) use was higher among women less than 15 years (ref: 20 - 24 years, RR 1.12, p < 0.001) and lower among women aged 18 - 19 years (RR 0.93, p = 0.009). Hispanic women had higher LARC use than non-Hispanic women (RR 1.07, p = 0.02). Compared to inpatient LARC placement, outpatient placement (1 - 4 weeks and 5 or more weeks) rates were lower (RR 0.77 and RR 0.89, respectively, p < 0.001). Time to subsequent delivery was shorter in non-LARC users (median 659 days) and non-contraception users (median 624 days) as compared to LARC users (median 790 days, p < 0.001); non-LARC postpartum contraceptive use did not significantly alter time to repeat delivery compared to women who used no method (p = 0.24).
Postpartum LARC use reduced the risk of repeat pregnancy with significant increase in time to the next delivery. Non-LARC use was no different from no contraceptive use in terms of time to repeat delivery.
Copyright © 2020. Published by Elsevier Inc.