Reproductive care and rates of pregnancy in teenagers with negative pregnancy test results

PurposeThe purpose of this study was to follow-up adolescent girls with negative pregnancy tests (NPTs) through an 18-month follow-up analysis of health services received, patterns of contraception use, and pregnancy outcomes.MethodThis study involved a retrospective review of medical records of 129 adolescent patients who had a NPT result from clinical sites in an urban medical center during a 3-month period in 1997. A stratified random sample of participants was selected from adolescents who received care at 2 school-based health centers, a women’s health center, and an adolescent health clinic associated with a large academic medical center.FindingsAnalysis of the 129 cases indicated that the cohort of adolescents with NPTs appears to be a higher risk group of girls than suggested by previous studies. Of the multi-ethnic sample with a mean age of 16.2 ± 1.4 years at the time of the NPT, 47% had already had 1 or more pregnancies and 25% had 1 child. Thirty percent of the subjects were offered condoms, and 50% were offered hormonal contraception at the time of the NPT; only 46% were given a return appointment. By 18 months after the index pregnancy test, 36% of the subjects had 1 or more pregnancies, and the majority of the subjects had used no form of contraception or had used contraception inconsistently.ConclusionsComprehensive reproductive health services often are not offered to adolescents who receive NPT results. Sexually active teenagers need thorough reproductive care and consistent follow-up evaluation to avoid sexually transmitted infections (STIs) and unintended pregnancies.