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Study Objective: In this study we aimed to collect and analyze CO levels as an indirect measure of smoke exposure in pregnant adolescents., Design, Setting, and Participants: Participants included pregnant adolescents who received antenatal care over 18 months (2012-2013) at the Multidisciplinary Teen Obstetrics Clinic at a tertiary-care hospital in Southeastern Ontario., Interventions: The CO breath test is a noninvasive method that is used to assess smoke exposure, in which nonsmokers have levels of 0-6 ppm, and levels of 7-10, 11-20 and more than 20 ppm are consistent with light, typical, and heavy smokers, respectively. Expired CO, smoking status, cigarette number, and home secondhand smoke exposure were documented at 3 clinic visits., Main Outcome Measures: To determine mean CO levels as a measure of smoke exposure and prevalence of secondhand smoke exposure., Results: The mean age of participants was 17.6 years. CO means (ppm) across 3 visits were 6.0, 5.9, and 4.8. Sixty-two percent of patients were self-reported nonsmokers, 38% were self-reported smokers (n = 93). CO means (standard error of the mean) were consistently different for nonsmokers vs smokers at visits 1 to 3, respectively: 2.9 (0.79) vs 9.7 (1.8); 3.0 (0.71) vs 12.9 (2.2), and 2.4 (0.71) vs 8.8 (1.5; P < .01, t test; n = 91). Of patient's highest CO (COmax), 62%, 9%, 15%, and 12% had levels of 6 or less, 7-10, 11-20, and greater than 20, respectively. Eighty-four percent of pregnant adolescents had home secondhand smoke exposure, which included 40% of nonsmokers and 100% of smokers (n = 57). Although most nonsmokers had a COmax of 6 or fewer ppm, 56% of smokers had COmax greater than 10 ppm (P < .05, χ(2))., Conclusion: Emphasis on smoking cessation is imperative in pregnant adolescents and should particularly target partners and families, because secondhand smoke exposure was very prevalent., (Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Study Objective: This study sought to analyze the effect of strategically timed local preventive education on reducing teen conception rates during known seasonal peaks in March and April., Design: All teen conceptions (age ≤ 19) from March and April 2010, 2011, and 2012 were identified using medical records data. Teen conceptions occurring in January 2010, 2011, and 2012 were also identified to control for any new trends in the community., Setting: A city of 160,000 with 1 tertiary care centre., Participants: Pregnant adolescents (age ≤ 19)., Interventions: During the month of February 2012, preventive education and media awareness strategies were aimed at parents, teachers, and teens., Main Outcome Measures: Adolescent conceptions in March and April 2012., Results: Conception rates in teens ≤18 years old were significantly reduced in March and April 2012 compared to March and April 2010 and 2011 (RR = 0.53, 95% CI = 0.32 - 0.88, P = .0132). There was an increase in conceptions in March and April 2012 compared to 2010 and 2011 among 19-year-olds (RR = 1.57, 95% CI = 0.84-2.9, P = .1500). Effect modification revealed our ≤18-year-old group and our 19-year-old group were distinct groups with different risk estimates (P = .0075)., Conclusions: Educational sessions were poorly attended and contraception clinic volume was static. We propose increased parental supervision in response to media reminders as a possible explanation for the reduction in adolescent conceptions (≤18 years old) seen in March 2012., (Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Study Objective: The objectives of this study were to determine if a seasonal trend exists in adolescent pregnancies and to compare the teen conception rate per month to an adult population., Setting: The study was conducted in a tertiary care Canadian hospital that has a one-site model of care., Design: A retrospective chart review of all adolescent pregnancies over a 5-year period (N = 838) was undertaken. From the 13,554 adult pregnancies over the same time period, a random sample of 838 pregnancies was chosen for similar chart review. A chi-square test was used to compare the proportion of pregnancies conceived in each calendar month between the two groups., Participants: Pregnancies ending in spontaneous abortions, elective terminations, ectopic pregnancies, as well as obstetrical deliveries, were included., Results: There was a significantly different monthly trend seen in adolescent pregnancy conceptions when compared with the adult group (χ² = 24.38, df = 11, P = 0.0112). The adolescent group was observed to have a unique peak in the number of pregnancies conceived in March (10.5% of pregnancies conceived compared to 7.3% in adults). In addition, 8.5% of conceptions in adolescents occurred in December compared to 10.4% in adults., Conclusions: There are several plausible explanations for the modest but real differences identified in this study including trends in fecundity/fertility or social/school events that lead to increased sexual activity. Peaks in conception indicate times when a greater need for health care services exists, and when preventive education can be most effective., (Copyright © 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Objective: To characterize the obstetric outcome and prevalence of anemia in primiparous adolescents and compare them with those in older primiparas., Methods: We conducted a retrospective chart review of 207 adolescents (or20 years old) whose prenatal care was provided by a single obstetrician in Kingston, Ontario, and who had a live singleton birth at >or24 weeks gestation between 1996 and 2004., Results: The mean age of the adolescents (T) was 17.5 years and of the adults (A) 27.3 years. More than 95% of the women were Caucasian. Mean gestational age at delivery was similar in the two groups (T 39.4 weeks, A 39.6 weeks, P = 0.25). Adolescents were more likely to have a preterm delivery (T 12.6%, A 7.5%, P = 0.038), although smoking rather than young maternal age was an independent risk factor for preterm delivery (odds ratio [OR] 3.2; 95% confidence intervals [CI] 1.47.5). A significantly lower proportion of adolescents delivered by Caesarean section (CS) (T 12.1%, A 27.7%, P < 0.001). Older maternal age, higher pre-pregnancy BMI, increased weight gain during pregnancy, and pre-delivery anemia were all independent risk factors for CS. Smoking was the most influential factor in predicting infant birth weight. Adolescents had significantly more low birth weight infants (< 2500 g) than adults (T 10.1% vs. A 4.3%, P = 0.008). Gestational age rather than young maternal age was the most significant risk factor for low birth weight (OR 3.3; 95% CI 1.95.7). After controlling for smoking status, adolescents were 2.5 times more likely than adults to be anemic at 26 to 35 weeks gestation and pre-delivery., Conclusion: Our results suggest that primiparous adolescents have significantly different obstetric outcomes from primiparous adults. Smoking and anemia are significant risk factors for poor obstetric outcomes and are potentially modifiable.

This article describes both barrier and spermicide methods of contraception including the male and female condom, diaphragm, contraceptive sponge, Lea Shield, cervical cap and multiple spermicide options. Their efficacy, differences and proper use are discussed with an emphasis on the adolescent user.