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Decline in adolescent fertility linked to increase in contraceptive use

Improvements in contraceptive use are significantly associated with the accelerated declines in pregnancy and birth rates among sexually active adolescent women in the United States from 2007 to 2012, according to recent study findings.

“To date, there has been limited research focused on identifying the causes of these rapid and large declines [adolescent pregnancy and birth rates] in the United States since 2007,” Laura Lindberg, PhD, of the Guttmacher Institute in New York, and colleagues wrote. “A focus on adolescent sexual activity and contraceptive use can improve our knowledge of the direct mechanisms driving the observed declines in adolescent pregnancy and childbearing.”

Lindberg and colleagues used the National Surveys of Family Growth to gather data on the sexual activity, contraceptive use, and contraceptive failure rates of adolescent women aged 15 to 19 years. They used this information to determine a Pregnancy Risk Index (PRI) for the years 2007, 2009, and 2012.

Change over time in sexual activity, contraceptive use, and PRI were monitored by a logistic regression model. In addition, the change in PRI in relation to changes in sexual activity or contraceptive use was analyzed by statistical decomposition.

Data indicated that there were no significant changes in sexual activity in the past 3 months throughout the duration of the study period. Substantial increases in the use of contraceptive methods (one method, 78% to 86%, P = .046; multiple methods, 26% to 37%, P = 0.46) were associated with the decline in pregnancy risk among adolescent women who were sexually active. In 2009, use of highly effective contraceptive methods significantly increased to 51% from 38% in 2007 (P = .01)

The PRI declined steadily from 2007 to 2012 at an annual rate of 5.6% (P = .071). This decline was associated with declines in birth and pregnancy rates. Lindberg and colleagues reported that this overall decline was solely due to improvements in contraceptive use.

“The rapid declines in adolescent pregnancy and births from 2007 to 2012 occurred despite stagnant rates of sexual activity. Instead, we find that the contraceptive behaviors of sexually active adolescents have driven the recent shifts in fertility outcomes,” the researchers concluded. “Efforts to further improve access to and use of contraception among adolescents are necessary to ensure they have the means to prevent pregnancy.” – by Alaina Tedesco

Disclosure: The researchers report that funding was provided by grants from the JB Picower Foundation and the Guttmacher Center for Population Research Innovation and Dissemination.