50% of adolescents who chose medical abortion have follow-up

  • Lee J & al.
  • J Pediatr Adolesc Gynecol
  • 10 Apr 2019

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Adolescents face barriers to medical abortion (MAB) follow-up but have higher rates of follow-up compared with older women.

Why this matters

  • 82% of pregnancies in adolescents are unplanned.
  • MAB (mifepristone and misoprostol) has a success rate of 95%-96%.

Key results

  • Follow-up rate was 51.8% for adolescents, 43.1% for 20-24-year-olds, 40.5% for 25-39-year-olds (P=.001).
  • 79.2% of adolescents received screening for sexually transmitted infections; 21.6% of those had a positive result.
  • 18.1% reported illicit substance use.
  • Black adolescents were less likely to have follow-up compared with Hispanic and non-Hispanic women (relative risk [RR], 0.76; 95% CI, 0.66-0.89).
  • Women in college were more likely to have follow-up (RR, 1.43; 95% CI, 1.03-1.98).
  • Of women who did have follow-up, 3.2% had a persistent intrauterine pregnancy.
  • Of women who followed-up, 18% chose long-acting reversible contraception; 18% selected no contraception.

Study design

  • Retrospective chart review.
  • Cohort from Cook County Hospital.
  • Adolescent patients (15-19 years) undergoing MAB were identified using a billing database (n=446).
  • For each adolescent, randomly selected patients age 20-24 years and age 25-39 years, respectively, were used for comparison.
  • Information on sociodemographics, follow-up, and contraception history extracted from records.
  • Funding: None.

Limitations

  • Low follow-up rates may affect true rate of MAB failure.