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To determine follow-up rates for adolescent patients who underwent medical abortion compared with adult patients, identify patient factors associated with follow-up, and evaluate contraceptive choices at the time of follow-up. A retrospective cohort study of adolescent patients (ages 15-19 years) who underwent first-trimester medical abortions at John H. Stroger, Jr. Hospital of Cook County from 2014 through 2017. None. Rate of follow-up after medical abortion, demographic factors associated with higher follow-up rates, and contraceptive choices by adolescents at follow-up encounters. During the study period, 8111 medication abortions were performed in our clinic. Adolescents accounted for 446 of these patients (446/8111; 5.5%). Among adolescents, the follow-up rate was 231/446 (51.8%). We determined the follow-up rates among a random sample of patients ages 20-24 years (n = 494) and 25-39 years (n = 397) to be 213/494 (43.1%), and 161/397 (40.5%), respectively. African American adolescents were significantly less likely to follow-up compared with their Hispanic and white counterparts (relative risk, 0.76; 95% confidence interval, 0.66-0.89). Those enrolled in college were significantly more likely to follow-up compared with those who reported lower levels of education (relative risk, 1.4; 95% confidence interval, 1.0-1.9). Only 2.5% of adolescents reported ever using a tier 1 contraception option before presenting for an abortion and among those who did follow-up, only 18% chose a tier 1 option for ongoing pregnancy prevention. Approximately half of our adolescent study population is at risk for undetected failed medical abortion and subsequent unplanned pregnancy. [ABSTRACT FROM AUTHOR]

Abstract Study Objective To examine characteristics of adolescent patients presenting for multiple terminations within 1 year and evaluate sexually transmitted infection (STI) status at each visit. Design, Setting, and Participants Cross-sectional retrospective chart review to identify women younger than age 20 years who underwent multiple abortions during 1 year at John H. Stroger, Jr Hospital of Cook County. Interventions None. Main Outcome Measures Rates and results of STI testing at each abortion encounter. Results We identified 381 adolescent patients with 2 or more abortions in 1 year. Of the 285 women who received STI testing at both clinical encounters, we identified 12 women with Chlamydia trachomatis (CT)/ Neisseria gonorrhoeae (GC) coinfection. Among patients who were not coinfected, 47 of 273 (17.2%) and 4 of 273 (1.5%) tested positive for CT and GC at the initial visit, respectively. Among women who were STI negative at the time of their first abortion, 25 of 226 (11.1%) were positive for CT and 1 of 269 (0.37%) was positive for GC at the time of their second termination. Conclusion Young women in our study had higher baseline rates of CT and GC than rates reported by the Centers for Disease Control and Prevention for an age-matched population. High rates of positivity at the second visit might indicate a need for increased health education and/or frequency of testing in high-risk groups. In the adolescent population for whom patient encounters can be limited, the abortion care visit provides an opportunity to provide education and mitigate risk. [ABSTRACT FROM AUTHOR]

Study Objective To evaluate the prevalence of anemia among female adolescents and young adults seeking abortion care at a county hospital, and to determine its associated factors. Design A cross-sectional retrospective study. Setting John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois. Participants Young women (N = 2916; ages 11-24 years) who underwent first trimester medical or surgical termination in 2016. Interventions and Main Outcome Measures Hemoglobin concentration at time of presentation, age, gestational age, body mass index, race/ethnicity, education, sexually transmitted infection status, and insurance status. Results On average, women were 21 (SD, 2.2) years old, 87% (2545 of 2916) African-American, and 64% (1863 of 2916) were Medicaid recipients. Gestational age at time of presentation ranged from 4 weeks 6 days to 13 weeks 6 days, and 58% (1695 of 2916) had surgical termination. Overall, 16% (451 of 2916) had hemoglobin concentrations of less than 11 g/dL. Categorization of severity showed that 4% (126 of 2916) of women had moderate and 11% (325 of 2916) had mild anemia. Only 2.6% of women (75 of 2916) had any history of anemia, and 91% (412 of 451) of anemic women did not have a preexisting anemia diagnosis. Fifteen percent of anemic women (51 of 451) had positive sexually transmitted infection screening, but positive status was not associated with anemia in crude or multivariable models ( P = .4-.6). In a multivariable model, later gestational age, decreasing body mass index, and multiparity were significantly associated with anemia prevalence after adjustment. Conclusion Our study showed an elevated prevalence of undiagnosed anemia. Ultimately, the abortion care setting can be an intersection for continued ambulatory care and provides an important opportunity to diagnose and educate young women on anemia management. [ABSTRACT FROM AUTHOR]