title: Prevalence of repeat pregnancies and associated factors among teenagers in KwaZulu-Natal, South Africa.
abstract: OBJECTIVE
  To determine the prevalence of repeat teenage pregnancy and the interval between first/most recent and repeat pregnancies, as well as to evaluate the sexual/reproductive health characteristics of teenagers with repeat pregnancies.
  
  
  METHODS
  A prospective observational study was undertaken at a hospital in KwaZulu-Natal, South Africa, between May and September 2013. Teenagers aged 13-19years who were pregnant, had recently delivered, or had terminated a pregnancy were enrolled. A questionnaire was used to obtain data.
  
  
  RESULTS
  Among 341 participants, 281 (82.4%) were seen for a first pregnancy and 60 (17.6%) for a repeat pregnancy. The interval between first/most recent and repeat pregnancies was 24months or lower in 45 (75.0%) of repeat pregnancy participants. Only 58 (17.0%) participants had previously used contraception (54 [93.1%] of whom stopped within 12months) and 28 (8.2%) had used emergency contraception. More participants with repeat pregnancy than with first pregnancy had a positive HIV status (18 [30.0%] vs 26 [9.3%]; P<0.001), more than one sexual partner in the past 12months (21 [35.0%] vs 35 [12.5%]; P<0.001), and a partner at least 5years older (38 [63.3%] vs 128 [45.6%]; P<0.001).
  
  
  CONCLUSIONS
  High repeat pregnancy rates, low contraception use, and high HIV prevalence among teenagers in South Africa is worrying. Focused interventions targeting teenagers following their first pregnancy need to be urgently implemented.
authors.affiliation: Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. Electronic address: mphatswe@ukzn.ac.za.
authors.forename: Wendy
authors.initials: W
authors.lastname: Mphatswe
authors.affiliation: Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Hopolang
authors.initials: H
authors.lastname: Maise
authors.affiliation: Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Motshedisi
authors.initials: M
authors.lastname: Sebitloane
mesh_terms: D000293:Adolescent; D001721:Birth Intervals / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adolescent reproductive health; Contraception; HIV; Repeat teenage pregnancy; Teenage pregnancy