Providing teenage girls with an infant simulator doll for a few days appeared to increase rather than decrease the risk of pregnancy, in a study from Western Australia.

The Australian Virtual Infant Parenting (VIP) programme was based on the American ‘Baby Think It Over’ programme and was aimed at girls aged 13 to 15. A total of 66 schools were invited to participate and 57 enrolled in the study. The schools were randomised to the VIP or control group.

The 1,267 girls on the VIP programme had four educational sessions in small groups with a school nurse, and were given a comprehensive workbook and a video documentary of teenage mothers relating their experience, and instructions on the infant simulator. They were provided with an infant simulator on a Friday afternoon to experience life as a virtual mother for a weekend.

The 1,567 girls in the control group were given usual advice through the standard curriculum.

The demography of the two groups of girls was broadly comparable. Slightly more control group girls had ever drunk alcohol (54% vs 39%) and had ever had sex (18% vs 15%) than VIP programme girls. Slightly fewer had ever been responsible for a baby (52% vs 59%). Educational and socioeconomic status was higher in control group girls.

The primary endpoint was pregnancy (live birth, stillbirth or induced abortion). There were 210 pregnancies in the 1,267 VIP programme girls (17%), and 168 among the 1,567 control group girls (11%) (chi-squared 20.8, P = 0.000044). There were 97 and 67 births respectively (chi-squared 14.7, P = 0.00044), and 113 and 101 terminations respectively (chi-squared 6.1, P = 0.013). The relative risk of pregnancy in VIP programme girls, adjusted for the variables mentioned above, was 1.36 (P = 0.0031).

Although in recent years the teenage pregnancy rate has been dropping, conception still occurred in 4,160 girls under the age of 16 in England and Wales in 2014.1 Various health promotion programmes have tried to reduce this rate still further.

The simulator is a sophisticated life-like baby doll that replicates the sleeping and feeding patterns of a real baby. The rational is that girls will find the simulated reality of life with a baby sufficiently intrusive into their social life and personal freedom that it will deter them from risking conception.

Quite why exposure to an infant simulator appears to increase the risk of teen pregnancy is unclear. The authors quote other studies where the investigators speculate that some girls believe that caring for a real baby would be easier than caring for the simulator, and that others may have enjoyed the attention they received while caring for the simulator.

Dr Chris Barclay

Brinkman SA, Johnson SE, Codde JP et al. Efficacy of infant simulator programmes to prevent teenage pregnancy: a school-based cluster randomised controlled trial in Western Australia. Lancet 2016. DOI: http://dx.doi.org/10.1016/S0140-6736(16)30384-1

Reference

1 www.ons.gov.uk/peoplepopulationandcommunity/ birthsdeathsandmarriages/conceptionandfertilityrates/ bulletins/conceptionstatistics/2014#main-points