Teens on Teratogenic Drugs Receiving Inadequate Contraceptive Provisions
(HealthDay News) — The rates of contraceptive provision for adolescents prescribed teratogens are low, according to a review published online Dec. 16 in Pediatrics.
Stephani L. Stancil, from the Children's Mercy Hospital in Kansas City, Mo., and colleagues conducted a retrospective review evaluating visits in 2008 to 2012 by adolescents aged 14 to 25 years in which a known teratogen was prescribed. Demographic information, evidence of contraceptive provision, and menstrual and sexual histories were examined.
The researchers found that 1,694 females received 4,506 prescriptions for teratogenic medications within 4,172 clinic visits. Topiramate, methotrexate, diazepam, isotretinoin, and enalapril were the most commonly prescribed teratogens. Neurology, hematology-oncology, and dermatology were the subspecialties that most frequently prescribed teratogens. In 28.6 percent of the visits, contraceptive provision was documented. Contraceptive provision was more likely for whites versus nonwhites and for older versus younger girls. The likelihood of contraceptive provision was increased with the presence of a federal risk mitigation system.
"Our data demonstrate female adolescents prescribed teratogens receive inadequate contraception provision, which could increase their risk for negative pregnancy outcomes," the authors write. "Although the presence of a federal risk mitigation system appears to improve contraceptive provision, these systems are costly and, in some instances, difficult to implement."