Canadian study: Teen pregnancies fell during pandemic

Key takeaways:

• Teen pregnancies in the Canadian province of Ontario declined during the COVID-19 pandemic.
• Visits for contraceptives and STI management also were down.

The rate of teen pregnancies in the Canadian province of Ontario fell during the COVID-19 pandemic, as did visits for contraceptive and sexually transmitted infection management, researchers found.

Existing inequities also were amplified because of a lack of adolescent sexual and reproductive health services, according to the researchers.

“The impact of the pandemic on [sexual and reproductive health] service access and outcomes among adolescents assigned female at birth is only beginning to be identified,” they wrote in Pediatrics.

One outcome of particular importance, the authors said, is adolescent pregnancy.

“With this study, we sought to examine changes in population-based rates of pregnancy and sexual health-related care utilization among female adolescents in a high-income country during the COVID-19 pandemic, and to evaluate the relationship of these outcomes with key sociodemographic characteristics, including rurality, neighborhood income quintile, immigration status, and geographic region,” they wrote.

The researchers conducted a population-based cross-sectional study of census data on 635,262 female adolescents aged between 12 and 19 years who resided in Ontario during a pre-pandemic period from Jan. 1, 2018, to Feb. 29, 2020, and from March 1, 2020, to Dec. 31, 2022.

In the pre-pandemic period, the authors found that the mean monthly rate of adolescent pregnancies was 0.82 per 1,000 adolescent females. Pregnancy rates dropped at the pandemic’s onset and remained lower than expected throughout the pandemic period, with an overall rate of 0.65 per 1,000 adolescent females, they found. The number of live births and abortions also declined during the pandemic.

Visits for contraception management and other essential services also had not returned to pre-pandemic levels at the end of the study period, although the health system had fully reopened, according to the study.

“Adolescents are early in their reproductive life course, and the pandemic may have [sexual reproductive health] implications that have not yet become evident; such impacts must be identified and attended to in a responsive, adolescent-centered, and rights-based manner that promotes optimal outcomes for all,” the researchers wrote.

The study was accompanied by a commentary authored by Laura K. Grubb, MD, MPH, FAAP, an attending physician in the division of adolescent and young adult medicine at Boston Children’s Hospital, who noted that it is possible that decreases in adolescent sexual reproductive health services could lead to persistent or widening inequities in unplanned pregnancies, teen births, increased STIs and fewer interactions with health care providers.

“By consistently screening for adolescent sexual reproductive health needs at all visits for all adolescents and by reducing barriers to care through novel approaches (eg, telehealth, providing contraceptive care at all appointments, supporting over-the-counter contraceptive access, universal STI screening), we can reduce adolescent sexual reproductive health inequities and improve outcomes for all adolescents and young adults,” Grubb wrote.

References:

Grubb LK. Pediatrics. 2024;doi:10.1542/peds.2023-064523.

Vandermorris A, et al. Pediatrics. 2024;doi:10.1542/peds.2023-063889.