Abstract
Objectives
To report teen pregnancy and sexually transmitted infections (STI) rates among Manitoba adolescents, and associated factors including rates of sexual intercourse and contraceptive use.
Methods
Teen pregnancy rates in females aged 15 to 19 for the fiscal years 1994/95 through 1998/99 were derived from the Population Health Research Data Repository and reported by geographical areas and income quintiles. Premature mortality rate (PMR) and the Socioeconomic Factor Index (SEFI) measured the overall health and socioeconomic well-being of regional populations. Data on sexual activity and contraceptive use were derived from the 1996 National Population Health Survey for males and females ages 15 through 19 years.
Results
The teen pregnancy rate for Manitoba was 63.2/1000, varying by geography and inversely correlated with income, PMR, and SEFI. 39% (95% CI 33-45) of teens reported sexual intercourse, with higher rates in urban areas (46%, 95 % CI 35-57) and the North (48%, 95% CI 36-60) compared to South Rural (30%, 95% CI 25-34), and in low-income families (68%, 95% CI 53-83) compared with middle/high (33%, 95% CI 26-40). For sexually active females, 42% (95% CI 28-57) used the birth control pill, with higher rates in low-income families (70%, 95% CI 50-90) compared to middle/high income (31%, 95% CI 14-48). Condom use (at last sexual intercourse) was reported by 82% (95% CI 72-92) of adolescents, with trends (though not statistically significant) to lower use in lowincome families and the North.
Conclusion
Reliance on the pill for contraception, combined with low rates of condom use, are public health concerns for adolescents where STI and unintended pregnancy rates are high.
Résumé
Objectifs
Déterminer les taux de grossesse et d’infections transmises sexuellement (ITS) chez les adolescents manitobains, ainsi que les facteurs associés, comme les taux de rapports sexuels et d’utilisation des contraceptifs.
Méthode
les taux de grossesse chez les adolescentes de 15 à 19 ans de 1994–1995 à 1998–1999, dérivés du Population Health Research Data Repository, sont présentés selon la zone géographique et le quintile de revenu. Le TMP et l’indice SEFI ont servi à mesurer l’état de santé global et le bienêtre socio-économique des populations régionales. Les données sur l’activité sexuelle et l’utilisation des contraceptifs sont dérivées des chiffres sur les adolescents de 15 à 19 ans dans l’Enquête nationale sur la santé de la population (1996).
Résultats
le taux de grossesse chez les adolescentes, au Manitoba, était de 63,2 %, avec quelques écarts géographiques, et était réciproquement corrélé avec le revenu, le TMP et le SEFI. Trente-neuf p. cent (IC de 95 % = 33-45) des adolescents déclaraient avoir eu des rapports sexuels; ce taux était plus élevé dans les agglomérations urbaines (46 %, IC de 95 % = 35-57) et dans le Nord (48 %, IC de 95 % = 36-60) que dans le Sud rural (30 %, IC de 95 % = 25-34), et plus élevé dans les familles à faible revenu (68 %, IC de 95 % = 53-83) que dans celles à revenu moyen ou élevé (33 %, IC de 95 % = 26-40). Chez les adolescentes sexuellement actives, 42 % (IC de 95 % = 28-57) prenaient la pilule anticonceptionnelle; ce taux était plus élevé dans les familles à faible revenu (70 %, IC de 95 % = 50-90) que dans celles à revenu moyen ou élevé (31 %, IC de 95 % = 14-48). L’utilisation du condom (lors du dernier rapport sexuel) était déclaré par 82 % des adolescents (IC de 95 % = 72-92); on a observé des taux inférieurs (sans être statistiquement significatifs) dans les familles à faible revenu et dans le Nord.
Conclusion
la confiance en la pilule pour la contraception, combinée aux faibles taux d’utilisation du condom, posent des problèmes de santé publique chez les populations adolescentes où les ITS et les taux de grossesse non désirée sont élevés.
Footnotes
The full report “Assessing the Health of Children in Manitoba: A Population-Based Study” on which this article is based is available from the Manitoba Centre for Health Policy at the above address or online at: http://www.umanitoba.ca/centres/mchp/reports.htm
Sources of support: This work was supported as part of a project on child health in Manitoba, one of several projects undertaken each year by the Manitoba Centre for Health Policy under contract to Manitoba Health. The results and conclusions are those of the authors and no official endorsement by Manitoba Health was intended or should be inferred. Dr. Martens was also supported by a Community Alliances for Health Research Program grant from the Canadian Institutes of Health Research.
Formerly from MCHP
References
- 1.Saskatchewan Health. Health Service and Outcome Indicators by Population Group: Mothers and Infants. Regina, Saskatchewan: Saskatchewan Health; 2000. [Google Scholar]
- 2.National Vital Statistics Reports (USA). Volume 48, No. 3. 2000. Available online at: https://doi.org/www.cdc.gov/nchs/releases/00news/nrbrth 98.htm
- 3.National Vital Statistics Reports (USA). Volume 47, No. 26. 2000. Available online at: https://doi.org/www.cdc.gov/nchs/releases/99news/teenpreg.htm
- 4.Forrest JD. Epidemiology of unintended pregnancy and contraceptive use. Am J Obstet Gynecol. 1994;170:1485–89. doi: 10.1016/s0002-9378(94)05008-8. [DOI] [PubMed] [Google Scholar]
- 5.Maynard R, Rangarajan A. Contraceptive use and repeat pregnancies among welfare-dependent teenage mothers. Fam Plann Perspect. 1994;26:198–205. doi: 10.2307/2135939. [DOI] [Google Scholar]
- 6.Olausson PMO, Cnattingius S, Goldenbert RL. Determinants of poor pregnancy outcomes among teenagers in Sweden. Obstet Gynecol. 1997;89:451–57. doi: 10.1016/S0029-7844(97)00009-4. [DOI] [PubMed] [Google Scholar]
- 7.Lao TT, Ho LF. Obstetric outcome of teenage pregnancies. Human Reproduction. 1998;13:3228–32. doi: 10.1093/humrep/13.11.3228. [DOI] [PubMed] [Google Scholar]
- 8.Cates W, Stone KM. Family planning, sexually transmitted diseases and contraceptive choice: A literature update - Part I. Fam Plann Perspect. 1992;24:75–84. doi: 10.2307/2135469. [DOI] [PubMed] [Google Scholar]
- 9.Cates W, Stone KM. Family planning, sexually transmitted diseases and contraceptive choice: A literature update - Part II. Fam Plann Perspect. 1992;24:122–28. doi: 10.2307/2135542. [DOI] [PubMed] [Google Scholar]
- 10.Trussell J, Hatcher RA, Cates W Jr, Stewart FH, Kost K. Contraceptive failure in the United States: An update. Stud in Fam Plann. 1990;21:51. doi: 10.2307/1966591. [DOI] [PubMed] [Google Scholar]
- 11.Communicable Disease Control6 Unit, Public Health Branch, Manitoba Health. Notifiable Diseases Manitoba: CDC Unit Annual Review Calendar Year 1996. Winnipeg: Manitoba Health; 2000. [Google Scholar]
- 12.Communicable Disease Control Unit, Public Health Branch, Manitoba Health. Discussion Paper for the Development of a Provincial Sexually Transmitted Diseases Control Strategy. Winnipeg: Manitoba Health; 2001. [Google Scholar]
- 13.Brownell M, Mayer T, Martens PJ, Kozyrskyj A, Fergusson P, Bodnarchuk J, et al. Using a population-based health information system to study child health. Can J Public Health. 2002;93(Suppl.2):S9–S14. doi: 10.1007/BF03403612. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Martens PJ, Frohlich N, Carriere K, Derksen S, Brownell M. Embedding child health within a framework of regional health: Population health status and sociodemographic indicators. Can J Public Health. 2002;93(Suppl.2):S15–S20. doi: 10.1007/BF03403613. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.World Health Organization. Youth Health Survey. 2000. [Google Scholar]
- 16.Martin K, Wu Z. Contraceptive use in Canada: 1984–1995. Fam Plann Perspect. 2000;32:65–73. doi: 10.2307/2648214. [DOI] [PubMed] [Google Scholar]
- 17.Kirby D, Waszak C, Ziegler J. Six school-based clinics: Their reproductive health services and impact on sexual behaviour. Fam Plann Perspect. 1991;23:6–16. doi: 10.2307/2135395. [DOI] [PubMed] [Google Scholar]
- 18.Weisman CS, Plichta S, Nathanson CA, Ensminger M, Robinson JC. Consistency of condom use for disease prevention among adolescent users of oral contraceptives. Fam Plann Perspect. 1991;23:71–74. doi: 10.2307/2135452. [DOI] [PubMed] [Google Scholar]
- 19.Finlay IG, Scott MGB. Patterns of contraceptive pill taking in an inner city practice. BMJ. 1986;293:601–2. doi: 10.1136/bmj.293.6547.601. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Klitsch M. How well do women comply with oral contraceptive regimens? Fam Plann Perspect. 1991;23:134–38. doi: 10.2307/2135826. [DOI] [PubMed] [Google Scholar]
- 21.Oakley D, Potter L, de Leon-Wong E, Visness C. Oral contraceptive use and protective behaviour after missed pills. Fam Plann Perspect. 1997;29:277–80. doi: 10.2307/2953417. [DOI] [PubMed] [Google Scholar]
- 22.Peterson LS, Oakley D, Potter LS, Darroch JE. Women’s efforts to prevent pregnancy: Consistency of oral contraceptive use. Fam Plann Perspect. 1998;30:19–23. doi: 10.2307/2991521. [DOI] [PubMed] [Google Scholar]