Pregnancy in adolescents electricity usage in the us


The topic of adolescent pregnancy arises in pediatric practice during discussions of sexual activity/contraception and during diagnostic evaluations for problems such as menstrual irregularities, gastrointestinal complaints, or pelvic mass. Adolescents may seek information regarding pregnancy directly from their health care provider. Laws regarding confidential pregnancy testing and counseling vary from state to state. (See "Confidentiality in adolescent health care" and "Consent in adolescent health care", section on ‘Consent for specific services’.)

The diagnosis and early clinical management of adolescent pregnancy relevant to the pediatric health care provider will be discussed here. The prevention of pregnancy, contraceptive issues, and an overview of the diagnosis and clinical manifestations of early pregnancy are discussed separately. Prenatal and postpartum care, pregnancy complications, and labor and delivery issues also are reviewed separately. (See "Contraception: Issues specific to adolescents" and "Clinical manifestations and diagnosis of early pregnancy".)

The teenage birth rate in the United States declined continuously between 1991 and 2005 [ 1]. Although it increased transiently between 2005 and 2007, it decreased to historic lows between 2007 and 2016 [ 1], largely related to increased contraceptive use and increased use of highly effective methods of contraception [ 2]. (See "Contraception: Issues specific to adolescents", section on ‘Choosing a method’.)

In 2016, the birth rates among teenagers aged 10 to 14 years and 15 to 19 years were 0.2 and 20.3 per 1000, respectively [ 1]. The overall birth rate for teenagers 15 to 19 years of age fell by 9 percent between 2015 and 2016: 11 percent for those 15 to 17 years of age and 8 percent for those 18 to 19 years of age. However, racial/ethnic disparities continue. The birth rate in Hispanic teens and non-Hispanic black teens was approximately twice that in non-Hispanic white teens; the birth rate in American Indian/Alaska Native teens was approximately 2.5 times that in non-Hispanic white teens [ 1]. Adolescents with mental health symptoms or major mental illness (eg, major depression, bipolar disorder, psychotic disorders) appear to be at increased risk of pregnancy [ 3,4].

Approximately 10 percent of all women aged 15 to 19, and 19 percent of those who have sexual intercourse, become pregnant. Most pregnancies among teenagers are unintended [ 5-7]. Among 15- to 19-year-old females with unintended pregnancies resulting in live births between 2004 and 2008, 50 percent were not using any method of contraception before the pregnancy (24 percent because their partner did not want to use contraception), 31 percent believed they could not get pregnant at the time, 13 percent had trouble getting contraception, and 22 percent did not mind if they got pregnant [ 8]. Surveillance data indicate that approximately 17 percent of births to teenagers 15 to 19 years of age in the United States in 2015 were repeat births [ 9]. Risk factors for repeat teenage pregnancy include depression, history of abortion, and living with a partner or increased partner support [ 10]. Protective factors include higher levels of education and use of contraception, particularly long-acting reversible contraceptives.