Contraceptive Use and Unintended Pregnancy in Women With Congenital Heart Disease
Contraceptive Use and Unintended Pregnancy in Women With Congenital Heart Disease
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DOI：
10.1097/aog.0000000000000911
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发表时间：
2015-08-01
影响因子：
7.2
通讯作者：
Billadello, Joseph J.
中科院分区：
文献类型：
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作者：
Lindley, Kathryn J.;Madden, Tessa;Billadello, Joseph J.
目的：在成人先天性心脏病学术实践中确定避孕药使用和妊娠的模式。在这项横断面研究中，从2013年10月到2014年3月，从学术性先天性心脏病诊所招募了100名年龄在18-45岁之间的先天性心脏病女性，并进行了有关怀孕史、避孕措施使用、了解与怀孕和避孕有关的风险。主要结局是目前使用长效可逆避孕药，包括宫内节育器或皮下植入物。结果：在83名性活跃的女性中，（75.9%，95%置信区间[CI] 65.3-85.1）报告目前使用任何避孕方法，包括83例中的30例（36.1%，95%CI 25.9-47.4），使用第一层方法（每年典型使用失败率小于1%），20/83例（24.1%，95%CI 15.4-34.7），使用第二层方法（每年典型使用失败率6-12%）。83例患者中有9例（10.8%，95% CI 5.1-19.6）报告目前使用长效可逆避孕措施。参与者自我报告141例怀孕中有64例（45.4%，95%CI 31.9-58.9）是意外怀孕，而不是计划怀孕。只有一个（1.6%，95%CI 0-4.6）的64个意外怀孕发生时，该妇女是使用一级I避孕方法的时间conception.CONCLUSION：大多数育龄期先天性心脏病的妇女性活跃。这一群体中意外怀孕的高发生率可能与高效避孕方法使用不足有关。对第一层方法的具体咨询可能会减少先天性心脏病妇女的意外怀孕。
OBJECTIVE: To identify patterns of contraceptive use and pregnancy in an academic adult congenital cardiology practice.METHODS: In this cross-sectional study, from October 2013 through March 2014, 100 women with congenital heart disease aged 18-45 years were recruited from an academic congenital heart disease clinic and administered a survey regarding pregnancy history, contraception use, and understanding of pregnancy-related and contraceptive-related risk. The primary outcome was current use of long-acting reversible contraception, including intrauterine devices or subdermal implants.RESULTS: Of 83 sexually active women, 63 (75.9%, 95% confidence interval [CI] 65.3-85.1) reported currently using any contraceptive method, including 30 of 83 (36.1%, 95% CI 25.9-47.4) using tier I methods (typical-use failure rates of less than 1% per year) and 20 of 83 (24.1%, 95% CI 15.4-34.7) using tier II methods (typical-use failure rates of 6-12% per year). Nine of 83 (10.8%, 95% CI 5.1-19.6) reported currently using long-acting reversible contraception. Sixty-four of 141 total pregnancies (45.4%, 95% CI 31.9-58.9) were self-reported by participants as unexpected rather than planned. Only one (1.6%, 95% CI 0-4.6) of the 64 unintended pregnancies occurred when the woman was using a tier I method of contraception at the time of conception.CONCLUSION: Most women with congenital heart disease of childbearing age are sexually active. The high incidence of unintended pregnancy in this group may be related to underuse of highly effective methods of contraception. Specific counseling on tier I methods may reduce unintended pregnancies in women with congenital heart disease.