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CDC: Young teens’ birth rates drop 67%

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Still more work to do

While it is encouraging that adolescent birth rates

continue to decline, the United

States continues to have one of the highest

adolescent birth rates of any developed country in the world. It is

particularly concerning that Hispanic and non-Hispanic black adolescents

continue to have about three times the birth rates of non-Hispanic white adolescents.

Equally alarming is that the majority of adolescents

report no formal sex education before their first sexual encounter. As a

community, we need to better prepare our young adolescents with evidence-based

information about sexual activity, contraception methods, and pregnancy. Just

as we vaccinate our community’s children to prevent illness, we need to talk to

our youth about sexual risk behaviors and what they can do to protect

themselves from pregnancy, sexually transmitted infections, and exploitation,

and to negotiate sexual relationships in a healthy manner. Parents and

educators need to have these conversations prior to sexual activity, so that

our youth can be prepared and protected, just as we do with vaccinations.

Providers and educators

can better prepare parents to have these discussions with young adolescents. There are many pregnancy prevention

programs, but not all of them have been proven to be effective. It is critical

that we use our limited resources in the employment of proven pregnancy

prevention programs.

This report highlights the adolescent birth trend from

1991 to 2012. There are many more effective contraceptive methods available

now, as compared to 1991. However, only 1% of adolescents are using the most

effective methods, which include intrauterine and implant contraception. Providers

can contribute to future declines in adolescent birth rates by educating

themselves about these contraceptive methods and counseling our youth about the

efficacy, safety, and satisfaction of intrauterine and implant contraceptives.

Dr. Amanda Jacobs is a pediatrician in the division of

adolescent medicine at the Children’s Hospital at Montefiore, Bronx, N.Y. Dr. Jacobs had no relevant disclosures.


 

FROM A CDC TELEBRIEFING

Despite a 67% drop in the birth rate among teens aged 15-17 years over the past 2 decades, there is still plenty of room for improvement, according to a report issued April 8 by the Centers for Disease Control and Prevention.

The rate of births per 1,000 teens aged 15-17 years fell from 51.9 in 1991 to 17.0 in 2012, a 67% drop. In 2012, 86,423 teens aged 15-17 years gave birth, which accounted for 28.3% of all births among teens aged 15-19 years. That’s down from 36% of all births to teens 15-19 years in 1991.


The rates among 15- to 17-year-olds varied widely by state and by ethnic and racial groups, with the highest rates among Hispanics (25.5 births per 1,000 teens) and non-Hispanic blacks (21.9), followed by American Indians/Alaska Natives (17.0). The lowest rates were among non-Hispanic whites and Asian/Pacific Islanders, at 8.4 and 4.1 births per 1,000 teens aged 15-17 years, respectively.

The researchers found no significant racial or ethnic differences in the percentage of female teens 15-17 years old who were sexually experienced or currently sexually active.

Across the United States, the rates among teens aged 15-17 years were the lowest in New Hampshire – 6.2 per 1,000 – and were highest in the District of Columbia – 29 per 1,000.

Among the report’s other findings:

• Between 2006 and 2010, 18% of female teens aged 15-17 years were sexually active.

• 90.9% of female teens aged 15-17 years had received formal sex education on either birth control or how to say no to sex, but only 61.3% received information on both topics.

• 23.6% had not discussed with their parents either saying no to sex or how to use contraceptives.

• 51.8% of the sexually active female 15- to 17-year-olds relied on less effective contraceptives, usually condoms, while 7.8% used no contraception.

• The most effective contraceptives, long-acting reversible contraceptives such as an intrauterine device, were used by 1% of sexually active females aged 15-17 years.

Courtesy CDC

Still more room for improvement: The CDC reports a 67% drop in the birth rate among teens over the last 20 years, but a multifaceted approach to prevention is needed to further improve those numbers.

Previous research suggested the 55% drop in pregnancies among 15- to 17-year-olds from 1995 through 2002 was because of changes in contraceptive use (accounting for 77% of the decline) and a decrease in sexual activity (responsible for 23% of the decline), the report’s authors noted. Therefore, they recommended that "efforts to prevent pregnancy in this population should take a multifaceted approach, including the promotion of delayed sexual initiation and the use of more effective contraceptive methods."

The report’s findings "are a reminder that we as health professionals have a special duty to give young people the necessary knowledge, the skills, and the encouragement to make healthy decisions and engage in healthy behaviors," explained Ileana Arias, Ph.D., principal deputy director of the Centers for Disease Control and Prevention (CDC) Agency for Toxic Substances and Disease Registry, during a telephone briefing.

The report is based on the CDC’s analysis of data on births from the National Vital Statistics System from 1991 to 2012 and on teen health behaviors from the National Survey of Family Growth from 2006 to 2010. The results were published in Morbidity and Mortality Weekly Report (2014;63:1-7).

Dr. Arias pointed out that the ages of 15, 16, and 17 years "are a critical time when a teen, especially a young woman, could jeopardize her future if she can’t complete high school or go to college."

emechcatie@frontlinemedcom.com

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