Centering contraception: postpartum contraceptive choices of women enrolled in Centering group prenatal care versus traditional prenatal care
Centering contraception: postpartum contraceptive choices of women enrolled in Centering group prenatal care versus traditional prenatal care
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中心避孕：参加中心组产前护理与传统产前护理的妇女的产后避孕选择
DOI：
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发表时间：
2018
影响因子：
3.3
通讯作者：
Erin Smith
中科院分区：
文献类型：
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作者：
Erin Smith
目的比较团体护理与传统产前护理对产后避孕选择的影响。方法采用回顾性队列研究方法，对参加集体护理和传统产前护理的产妇产后避孕选择进行评价。患者来自美国特拉华州纽瓦克克里斯蒂娜医院2009年1月1日至2014年12月31日期间所有分娩的数据库。在这个数据库中，识别了产前护理患者组，并创建了一组2：1匹配的类似传统产前护理患者。这些妇女使用的避孕方法是通过图表检查确定的。计算在每种护理模式中使用每种方法的妇女比例。采用多项Logistic回归进行统计分析。结果进入最终分析的867例患者中，289例为观察组，587例为传统产前护理组。两组在绝育、避孕套、注射和其他短效荷尔蒙避孕方法(贴片、阴道环和药丸的混合物)的选择上相似。产前护理组患者更倾向于产后避孕(用NO方法测得的AOR0.50，95% CI0.32~0.78，P=0.002)，尤其是长效可逆避孕药(OR1.67，95% CI1.16~2.40，P=0.005)。这一差异在20-24岁的女性中最为明显(AOR1.98，95% 可信区间1.10至3.56)。结论与传统产前护理不同，集体产前护理增加了产后避孕措施的使用，并增加了对LARC的摄取。小组产前护理参与与LARC使用之间的关联在20-24岁的女性中尤为明显。
Objective To assess postpartum contraceptive choices of women participating in group versus traditional prenatal care. Methods This is a retrospective cohort study assessing postpartum contraceptive choices of women participating in group versus traditional prenatal care. Patients were derived from a database of all deliveries from 1 January 2009 to 31 December 2014 at Christiana Hospital in Newark, Delaware, USA. Within this database, group prenatal care patients were identified and a two-to-one matched set of similar traditional prenatal care patients was created. Contraceptive methods utilised by these women were ascertained via chart review. The proportion of women using each method in each care model was calculated. Multinomial logistic regression was carried out for statistical analysis. Results Included in the final analysis were 867 patients: 289 group and 587 traditional prenatal care participants. Groups were similar in selection of sterilisation, condoms, injection, and other short-acting hormonal contraceptive methods (a composite of patch, vaginal ring, and pills). Group prenatal care patients were more likely to utilise contraception postpartum (as measured by use of no method with AOR 0.50, 95% CI 0.32 to 0.78, P=0.002), particularly long-acting reversible contraceptives (LARCs) (OR 1.67, 95% CI 1.16 to 2.40, P=0.005). This difference was most pronounced for women aged 20–24 years (AOR 1.98, 95% CI 1.10 to 3.56). Conclusion Participation in group prenatal care as opposed to traditional prenatal care increases use of postpartum contraception and increases uptake of LARCs. The association of group prenatal care participation with LARC use is particularly apparent for women aged 20–24 years.