Abstract：
OBJECTIVE: Multiparous teens, compared to primiparous teens, are at increased risk for adverse neonatal and maternal outcomes. Long-acting reversible contraception (LARC) is infrequently used among postpartum teens. This study identifies predictors of teens\' intentions to use LARC postpartum when it is widely available.
METHODS: Colorado teens who were patients during their pregnancy in an adolescent-centered clinic where all common methods of contraception were easily accessible were surveyed in clinic during their third trimester and following delivery regarding life circumstances (relationships, stress, and family function) and intended method of postpartum contraception. Multinomial logistic regression analyses were used to examine predictors of intended postpartum contraceptive method: LARC, non-LARC effective (condoms, birth control pills, shot, patch, or ring), or low-effective method or no contraception (abstinence, no method, or undecided).
RESULTS: A total of 1203 patients were enrolled. Greater life stress was associated with greater likelihood of intending to use low-effective contraception versus LARC postpartum. Teens in a longer relationship with their baby\'s father (versus those never in a relationship with the baby\'s father) were less likely to intend to use low-effective contraception or non-LARC effective methods and more likely to intend to use LARC postpartum.
CONCLUSIONS: When structural barriers are minimized, non-clinical factors such as relationship context and life stress are most associated with postpartum LARC use intentions. Health care providers can help teen patients obtain the postpartum contraception the patients believe is best by employing developmentally appropriate, person-centered care that is sensitive to life stressors and relationship context.
METHODS: Colorado teens who were patients during their pregnancy in an adolescent-centered clinic where all common methods of contraception were easily accessible were surveyed in clinic during their third trimester and following delivery regarding life circumstances (relationships, stress, and family function) and intended method of postpartum contraception. Multinomial logistic regression analyses were used to examine predictors of intended postpartum contraceptive method: LARC, non-LARC effective (condoms, birth control pills, shot, patch, or ring), or low-effective method or no contraception (abstinence, no method, or undecided).
RESULTS: A total of 1203 patients were enrolled. Greater life stress was associated with greater likelihood of intending to use low-effective contraception versus LARC postpartum. Teens in a longer relationship with their baby\'s father (versus those never in a relationship with the baby\'s father) were less likely to intend to use low-effective contraception or non-LARC effective methods and more likely to intend to use LARC postpartum.
CONCLUSIONS: When structural barriers are minimized, non-clinical factors such as relationship context and life stress are most associated with postpartum LARC use intentions. Health care providers can help teen patients obtain the postpartum contraception the patients believe is best by employing developmentally appropriate, person-centered care that is sensitive to life stressors and relationship context.
摘要：
目标：多胎青少年，与初产妇相比，新生儿和产妇不良结局的风险增加。长效可逆避孕（LARC）在产后青少年中很少使用。这项研究确定了青少年意图使用LARC产后广泛可用的预测因素。
方法：科罗拉多州的青少年在以青少年为中心的诊所怀孕期间的患者中，所有常见的避孕方法都很容易获得，他们在妊娠晚期和分娩后的生活情况（关系，压力，和家庭功能）和预期的产后避孕方法。多项logistic回归分析用于检查预期的产后避孕方法的预测因子：LARC，非LARC有效(避孕套，避孕药,射击,补丁,或环)，或低效率的方法或不避孕(禁欲，没有方法,或未定)。
结果：纳入1,203例患者。与LARC相比，更大的生活压力与打算使用低有效避孕方法的可能性更大有关。与婴儿父亲关系较长的青少年（与从未与婴儿父亲有关系的青少年相比）不太可能打算使用低有效避孕或非LARC有效方法，更有可能打算使用LARC产后。
结论：当结构性障碍最小化时，非临床因素,如人际关系背景和生活压力,与产后LARC使用意向最相关.医疗保健提供者可以帮助青少年患者获得患者认为最好的产后避孕方法，以人为中心的护理，对生活压力源和关系背景敏感。
方法：科罗拉多州的青少年在以青少年为中心的诊所怀孕期间的患者中，所有常见的避孕方法都很容易获得，他们在妊娠晚期和分娩后的生活情况（关系，压力，和家庭功能）和预期的产后避孕方法。多项logistic回归分析用于检查预期的产后避孕方法的预测因子：LARC，非LARC有效(避孕套，避孕药,射击,补丁,或环)，或低效率的方法或不避孕(禁欲，没有方法,或未定)。
结果：纳入1,203例患者。与LARC相比，更大的生活压力与打算使用低有效避孕方法的可能性更大有关。与婴儿父亲关系较长的青少年（与从未与婴儿父亲有关系的青少年相比）不太可能打算使用低有效避孕或非LARC有效方法，更有可能打算使用LARC产后。
结论：当结构性障碍最小化时，非临床因素,如人际关系背景和生活压力,与产后LARC使用意向最相关.医疗保健提供者可以帮助青少年患者获得患者认为最好的产后避孕方法，以人为中心的护理，对生活压力源和关系背景敏感。
