Objectives
To determine pregnancy risk and receptiveness to emergency department (ED)-based pregnancy prevention interventions among adolescents accessing care in the ED.
Study design
Cross-sectional electronic survey of adolescent females in a pediatric ED used to calculate the pregnancy risk index (PRI), a validated measure estimating the annual risk of becoming pregnant based upon recent sexual activity, contraceptive method(s), and method-specific contraceptive failure rates) and interest in receipt of ED-based contraceptive services.
Results
Of 229 participants, 219 were non-pregnant, and 129 reported sexual experience. 72.4% (n=166) endorsed negative pregnancy intentions. The overall PRI for the 219 non-pregnant participants was 9.6 (95% CI 6.8, 12.4), and was 17.5 (95% CI 12.8, 22.2) for the 129 sexually experienced participants. A PRI above the national average of 5 was associated with older age (aOR 3.0; 95% CI 1.5, 5.85), non-private insurance (aOR 7.1; 95% CI 1.6, 32.1), prior pregnancy (aOR 2.7; 95% CI 1.2, 6.0), and chief complaint potentially related to a reproductive health concern (aOR 2.6; 95% CI 1.4, 5.1). 85.1% (n=194) believed that the ED should provide information about pregnancy prevention, the majority of whom (64.9%; n=148) believed that pregnancy prevention services should be offered at all ED visits.
Conclusion
This study demonstrates a high unintended pregnancy risk among adolescents accessing care in the ED. Adolescents report interest in receiving pregnancy prevention information and services in the ED, regardless of reason for visit. Strategies to successfully incorporate the provision of reproductive health services into ED care should be explored.