{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T08:48:14Z","timestamp":1765356494455,"version":"3.41.2"},"reference-count":38,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>Timely contraceptive initiation is increasingly common, yet population trends by method and among subgroups with increased risk of unintended pregnancy are not well described. The impact of timing and type of contraceptive initiation on risk of unwanted pregnancy is unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We used nationally representative cross-sectional data from 4 cycles of the National Survey of Family Growth, 2002\u20132015. We calculated outcomes from self-reported dates of sexual debut, contraceptive initiation, and unwanted pregnancy. We compared trends in timely contraceptive initiation (within 1 month of sexual debut) by method and by race and\/or ethnicity and income. Using multivariable regression, we identified predictors of delayed contraceptive initiation. We compared the risk of unwanted pregnancy for delayed versus timely contraceptive initiation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>We analyzed responses from 26\u2009359 women with sexual debuts in 1970\u20132014. One in 5 overall and 1 in 4 African American, Hispanic, or low-income respondents reported delayed contraceptive initiation, which was associated with unwanted pregnancy within 3 months of sexual debut (adjusted risk ratio 3.7 versus timely contraceptive initiation; 99.9% confidence interval: 2.3\u20135.9; P &amp;lt; .001). Timely contraceptive initiation with less effective versus effective methods was not associated with unwanted pregnancy within 3 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Delayed contraceptive initiation is more common among African American, Hispanic, and low-income women and is strongly associated with short-term risk of unwanted pregnancy. Pediatricians play a key role in making timely contraception available to adolescents at or before sexual debut. More research is needed to understand the importance of early contraceptive methods on pregnancy risk.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2018-2463","type":"journal-article","created":{"date-parts":[[2019,1,15]],"date-time":"2019-01-15T13:25:31Z","timestamp":1547558731000},"source":"Crossref","is-referenced-by-count":10,"title":["Contraceptive Initiation Among Women in the United States: Timing, Methods Used, and Pregnancy Outcomes"],"prefix":"10.1542","volume":"143","author":[{"given":"Mara E.","family":"Murray Horwitz","sequence":"first","affiliation":[{"name":"Harvard Pilgrim Health Care Institute, Boston, Massachusetts;"},{"name":"Harvard Medical School, Harvard University, Boston, Massachusetts; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Ross-Degnan","sequence":"additional","affiliation":[{"name":"Harvard Pilgrim Health Care Institute, Boston, Massachusetts;"},{"name":"Harvard Medical School, Harvard University, Boston, Massachusetts; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lydia E.","family":"Pace","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Harvard University, Boston, Massachusetts; and"},{"name":"Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2019,2,1]]},"reference":[{"issue":"5","key":"2021121021320932100_B1","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1542\/peds.2012-3495","article-title":"Sexual initiation, contraceptive use, and pregnancy among young adolescents.","volume":"131","author":"Finer","year":"2013","journal-title":"Pediatrics"},{"issue":"3","key":"2021121021320932100_B2","doi-asserted-by":"crossref","first-page":"e271","DOI":"10.1016\/j.whi.2014.02.002","article-title":"Trends in ages at key reproductive transitions in the United States, 1951-2010.","volume":"24","author":"Finer","year":"2014","journal-title":"Womens Health Issues"},{"key":"2021121021320932100_B3","doi-asserted-by":"crossref","first-page":"S336","DOI":"10.2105\/AJPH.2018.304556","article-title":"Trends and disparities in sexual and reproductive health behaviors and service use among young adult women (aged 18-25 years) in the United States, 2002-2015.","volume":"108","author":"Murray Horwitz","year":"2018","journal-title":"Am J Public Health"},{"issue":"9","key":"2021121021320932100_B4","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1056\/NEJMsa1506575","article-title":"Declines in unintended pregnancy in the United States, 2008-2011.","volume":"374","author":"Finer","year":"2016","journal-title":"N Engl J Med"},{"issue":"2","key":"2021121021320932100_B5","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s10995-009-0546-2","article-title":"Intention to become pregnant and low birth weight and preterm birth: a systematic review.","volume":"15","author":"Shah","year":"2011","journal-title":"Matern Child Health J"},{"issue":"2","key":"2021121021320932100_B6","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s10995-009-0446-5","article-title":"Pregnancy outcomes by pregnancy intention in a managed care setting.","volume":"14","author":"Postlethwaite","year":"2010","journal-title":"Matern Child Health J"},{"issue":"6","key":"2021121021320932100_B7","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/j.jadohealth.2016.03.006","article-title":"Determinants and correlates of preventive behaviors at first sex with a first partner and second partner: analysis of the FECOND study.","volume":"58","author":"Lantos","year":"2016","journal-title":"J Adolesc Health"},{"issue":"6","key":"2021121021320932100_B8","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/00007435-200406000-00010","article-title":"Is condom use habit forming?: condom use at sexual debut and subsequent condom use.","volume":"31","author":"Shafii","year":"2004","journal-title":"Sex Transm Dis"},{"issue":"8","key":"2021121021320932100_B9","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1093\/humrep\/deu085","article-title":"Timing of contraceptive initiation and association with future sexual and reproductive outcomes.","volume":"29","author":"True","year":"2014","journal-title":"Hum Reprod"},{"issue":"21","key":"2021121021320932100_B10","first-page":"1","article-title":"Sexual activity and contraceptive practices among teenagers in the United States, 1988 and 1995","author":"Abma","year":"2001","journal-title":"Vital Health Stat 23"},{"key":"2021121021320932100_B11","unstructured":"Abma\u2008JC, Martinez\u2008GM. 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