We aimed to retrospectively estimate adolescent fertility rates before and after a large-scale natural disaster.

A case-control study was conducted in Aceh Province, Indonesia, 2 years after the Indian Ocean tsunami in 2004. The age-specific fertility rates of 15–19-year-old-women (ASFR 15–19) was estimated each year from 2004 to 2006 by creating hypothetical age cohorts. The results were compared with data from the closest edition of the Indonesian Demographic Health Survey (IDHS).

The pre-disaster ASFR 15–19 (4.4% in 2004) was not significantly different from the 2002–2003 IDHS data (P=0.49), whereas the post-disaster ASFR 15–19 (1.1% in 2005–2006) was significantly lower than the provincial estimation in the 2007 IDHS (P<0.01). ASFR 15–19 was reduced by 76% in the post-disaster period compared with the pre-disaster period (rate ratio: 0.24, P=0.02).

The creation of hypothetical age cohorts enabled valid and useful estimation of the ASFR in disaster-affected areas where reliable vital statistics are not available. For pre-disaster fertility estimation, however, we suggest excluding data from the 40-week period preceding the disaster, because the data may be biased by excess mortality in childbearing mothers and newborn babies in the disaster. (Disaster Med Public Health Preparedness. 2016;10:80–86)