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CME Credit Offered
CME Credit Offered
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Poster Session 4

(1073) Short-interval births among adolescents who received immediate postpartum long-acting reversible contraception

Friday, January 31, 2025
4:00 PM – 6:00 PM  
Objective: Adolescent pregnancy is linked to adverse maternal and neonatal outcomes and is associated with short interval birth, further exacerbating these risks. Contraceptive counseling and access can decrease rates of short-interval birth, especially in this high-risk population. Tennessee faces high rates of both adolescent pregnancies and SIB, with 32.5% of pregnancies following a prior live birth having <18 months of birth spacing (2018-2020 average). In 2018, a statewide quality improvement project introduced immediate postpartum long-acting reversible contraception (IPP LARC) for publicly insured recipients. This study aims to assess SIB rates among adolescents who received IPP LARC.

Study Design: This retrospective study utilized billing data for publicly insured adolescents (≤20 years old) giving birth from January 2018-December 2019. These data were matched by SSN, date of birth, and mother’s name with statewide birth certificate records from January 2015-December 2021. SIB was defined as two births ≤24 months apart. Among multiparous patients, SIB prior to and after receiving IPP LARC was assessed.

Results: We identified 267 adolescent deliveries. IPP arm implants were inserted more often than intrauterine devices (IUDs) (65.5% vs 34.5%) (Figure1) in these adolescents. Of the 267, 62.0% (n=165) were primiparous (Table 1). Among multiparous patients (n=101), 56.4% (n=57) had a SIB prior to IPP LARC placement. The median number of previous live births among multiparous was 1.0 (IQR:1,2). Among the multiparous patients with a prior SIB, 90.7% (49) did not have another SIB post LARC. Among the entire cohort, 8.2% (n=22) of deliveries had a SIB after IPP LARC placement.

Conclusion: Adolescents electing IPP LARC had low subsequent SIB rates. Addressing adolescent pregnancy is a public health priority, and, although secondary prevention, access to desired IPP LARC is a strategy to decrease repeat adolescent pregnancies and short interval births.