Addendum--adolescent pregnancy: current trends and issues.

Abstract

The purpose of this addendum is to update pediatricians and other professionals on recent research and data regarding adolescent sexuality, contraceptive use, and childbearing since publication of the original 2005 clinical report, “Adolescent Pregnancy: Current Trends and Issues.”1 There has been a trend of decreasing sexual activity and teen births and pregnancies since 1991, except between the years of 2005 and 2007, when there was a 5% increase in birth rates. Currently, teen birth rates in the United States are at a record low secondary to increased use of contraception at first intercourse and use of dual methods of condoms and hormonal contraception among sexually active teenagers.2 Despite these data, the United States continues to lead other industrialized countries in having unacceptably high rates of adolescent pregnancy, with over 700 000 pregnancies per year, the direct health consequence of unprotected intercourse.3 Importantly, the 2006–2010 National Survey of Family Growth (NSFG) revealed that less than one-third of 15- to 19-year-old female subjects consistently used contraceptive methods at last intercourse.4 Most pregnancies among adolescents in the United States are unintended (unwanted or mis-timed). In fact, 88% of births to teenagers 15 to 17 years of age were the result of unintended pregnancies.5 Births to 15- to 19-year-old female subjects peaked in 1991 at 61.8 per 1000 female subjects; subsequently, the rate decreased annually, except for a slight increase in 2005–2007, to reach its nadir at 39.1 per 1000 female subjects in 2011.6 Birth rate statistics are not the same as pregnancy rate statistics. Birth rate statistics underestimate actual adolescent pregnancy rates. The birth rate numerator includes the number of actual births per 1000 individuals in that age group, but the pregnancy rate includes actual births, abortions, and best estimates of fetal loss per 1000 adolescents in that …