title: Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials.
abstract: OBJECTIVE
  To review the effectiveness of primary prevention strategies aimed at delaying sexual intercourse, improving use of birth control, and reducing incidence of unintended pregnancy in adolescents.
  
  
  METHODS
  12 electronic bibliographic databases, 10 key journals, citations of relevant articles, and contact with authors.
  
  
  METHODS
  26 trials described in 22 published and unpublished reports that randomised adolescents to an intervention or a control group (alternate intervention or nothing).
  
  
  METHODS
  Two independent reviewers assessed methodological quality and abstracted data.
  
  
  RESULTS
  The interventions did not delay initiation of sexual intercourse in young women (pooled odds ratio 1.12; 95% confidence interval 0.96 to 1.30) or young men (0.99; 0.84 to 1.16); did not improve use of birth control by young women at every intercourse (0.95; 0.69 to 1.30) or at last intercourse (1.05; 0.50 to 2.19) or by young men at every intercourse (0.90; 0.70 to 1.16) or at last intercourse (1.25; 0.99 to 1.59); and did not reduce pregnancy rates in young women (1.04; 0.78 to 1.40). Four abstinence programmes and one school based sex education programme were associated with an increase in number of pregnancies among partners of young male participants (1.54; 1.03 to 2.29). There were significantly fewer pregnancies in young women who received a multifaceted programme (0.41; 0.20 to 0.83), though baseline differences in this study favoured the intervention.
  
  
  CONCLUSIONS
  Primary prevention strategies evaluated to date do not delay the initiation of sexual intercourse, improve use of birth control among young men and women, or reduce the number of pregnancies in young women.
authors.affiliation: School of Nursing, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5. dicensoa@mcmaster.ca
authors.forename: Alba
authors.initials: A
authors.lastname: DiCenso
authors.forename: Gordon
authors.initials: G
authors.lastname: Guyatt
authors.forename: A
authors.initials: A
authors.lastname: Willan
authors.forename: L
authors.initials: L
authors.lastname: Griffith
mesh_terms: D000293:Adolescent; D003268:Contraception Behavior / Q000706:statistics & numerical data; D005193:Family Planning Services / Q000706:statistics & numerical data; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D011320:Primary Health Care / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012746:Sexual Abstinence; D012725:Sexual Behavior