title: Consultation patterns and provision of contraception in general practice before teenage pregnancy: case-control study.
abstract: OBJECTIVE
  To determine patterns of consultation in general practice and provision of contraception before teenage pregnancy.
  
  
  METHODS
  Case-control study, with retrospective analysis of case notes.
  
  
  METHODS
  14 general practices in Trent region.
  
  
  METHODS
  240 registered patients (cases) with a recorded conception before the age of 20. Three controls per case were matched by age and practice.
  
  
  METHODS
  Consultations in general practice and provision of contraception in the 12 months before conception and recorded provision of contraception at any time before conception.
  
  
  RESULTS
  Overall, 223 cases (93%) had consulted a health professional at least once in the year before conception, 171 (71%) had discussed contraception in this time, and 121 (50%) had been prescribed oral contraception. Cases were more likely to have consulted in the year before conception than controls (odds ratio 2. 70, 95% confidence interval 1.56 to 4.66). Most of the difference was owing to consultation for contraception. Overall, 53 cases (22%) resulted in a termination of pregnancy. Cases whose pregnancy ended in a termination were more likely to have received emergency contraception than either their controls (3.21, 1.32 to 7.79) or cases resulting in other outcomes (3.01, 1.06 to 8.51).
  
  
  CONCLUSIONS
  Most teenagers who became pregnant attended general practice in the year before pregnancy, and many had sought contraceptive advice. The reluctance of teenagers to attend general practice for contraception may be less than previously supposed. The association between provision of emergency contraception and pregnancy ending in termination emphasises the need for continuing follow up of teenagers consulting for this form of contraception.
authors.affiliation: Division of General Practice, University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH, UK. dick.churchill@nottingham.ac.uk
authors.forename: D
authors.initials: D
authors.lastname: Churchill
authors.forename: J
authors.initials: J
authors.lastname: Allen
authors.forename: M
authors.initials: M
authors.lastname: Pringle
authors.forename: J
authors.initials: J
authors.lastname: Hippisley-Cox
authors.forename: D
authors.initials: D
authors.lastname: Ebdon
authors.forename: M
authors.initials: M
authors.lastname: Macpherson
authors.forename: S
authors.initials: S
authors.lastname: Bradley
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D003267:Contraception; D003695:Delivery of Health Care; D005194:Family Practice; D005260:Female; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D006113:United Kingdom