International http://std.sagepub.com/ Journal of STD & AIDS Seven years of teenage pregnancy in an inner London genitourinary medicine service − a retrospective cohort study Aseel Hegazi, Natalie Daley, Elizabeth Williams, Felicity McLeod, Saba Rafiezadeh and Katia Prime Int J STD AIDS published online 11 March 2014 DOI: 10.1177/0956462414527263 The online version of this article can be found at: http://std.sagepub.com/content/early/2014/03/11/0956462414527263

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Int J STD AIDS OnlineFirst, published on March 11, 2014 as doi:10.1177/0956462414527263

Original research article

Seven years of teenage pregnancy in an inner London genitourinary medicine service – a retrospective cohort study

International Journal of STD & AIDS 0(0) 1–6 ! The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0956462414527263 std.sagepub.com

Aseel Hegazi, Natalie Daley, Elizabeth Williams, Felicity McLeod, Saba Rafiezadeh and Katia Prime

Abstract Young people attending genitourinary medicine services are at high risk of unplanned pregnancy. We performed a retrospective cohort study to identify characteristics of pregnant teenagers accessing an inner London genitourinary medicine service. There were 481 pregnancies in 458 teenagers with 54 previous pregnancies and 46 previous terminations of pregnancy. The under-18 and under-16 teenage pregnancy rates were 92.1 and 85.8 per 1000 age-matched clinic attendees, respectively. Median age was 17.1 years. ‘Black Other’ teenagers (‘Black British’, ‘Mixed White-Black Caribbean’ and ‘Mixed White-Black African’) were over-represented, compared to our clinic population, while those of White ethnicity were under-represented. Few pregnancies (1.5%) were planned with the majority (64%) intending terminations of pregnancy. Most teenagers did not use consistent contraception. Two-thirds of patients had attended genitourinary medicine services in the past and sexually transmitted infection prevalence at presentation was high. Effectively targeting the sexual and reproductive health needs of teenage genitourinary medicine clinic attendees may have a significant impact on reducing sexually transmitted infections, unplanned pregnancy and terminations of pregnancy in this group.

Keywords Europe, location, women, sexual behaviour Date received: 21 August 2013; accepted: 10 February 2014

Introduction Reducing the under-18 teenage pregnancy rate (TPR) has been a national public health priority since the publication of the Social Exclusion Unit’s Teenage Pregnancy report in 1999.1 Since the launch of England’s Teenage Pregnancy Strategy over 10 years ago, the under-18 conception rate has dropped by 34% from 47.1 to 30.9 conceptions per 1000 women in 2011, the lowest figure since records began in 1969.2 Despite this success, the UK still has a TPR higher than that seen in most developed countries and has the highest TPR in Western Europe.3 Lower socio-economic status and social exclusion are the most consistent factors strongly associated with an increased risk of teenage pregnancy.4–7 In the UK, those identifying their ethnicity as Black Caribbean’, ‘Mixed White-Black Caribbean’ or ‘Black Other’ (‘Black British’ who do not identify as either

Black African or Black Caribbean) are significantly over-represented among teenage mothers.7 Other factors include: ‘having a mother who herself had a teenage pregnancy, living in a lone parent family, early menarche (

Seven years of teenage pregnancy in an inner London genitourinary medicine service - a retrospective cohort study.

Young people attending genitourinary medicine services are at high risk of unplanned pregnancy. We performed a retrospective cohort study to identify ...
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