Variation in effectiveness of planned postpartum contraception at two time points from prenatal to postpartum care.
Variation in effectiveness of planned postpartum contraception at two time points from prenatal to postpartum care.
复制标题
DOI：
10.1016/j.contraception.2020.06.002
复制
发表时间：
2020-10
期刊：
影响因子：
2.9
通讯作者：
Arora KS
中科院分区：
文献类型：
--
作者：
Bhide S;Ascha M;Wilkinson B;Verbus E;Montague M;Morris J;Arora KS
确定从产前到产后护理在避孕有效性方面有一致计划的妇女的特征，以及一致性是否影响避孕结局。这是对2012年至2014年在单一三级保健中心分娩的女性进行的回顾性图表审查的二次分析。在三个时间点（产前护理、出院和门诊产后护理）提取首选产后避孕计划，并将其分为三个有效性级别。然后，我们检查了前两个时间点之间计划的产后避孕方法的有效性的一致性。在研究队列的8，394名妇女中，2，642名（31.5%）在前两个时间点计划了一致的产后避孕措施。具有一致避孕偏好的女性更可能具有较高的产次（产次2+的aOR 2.36，95% CI 2.06-2.70），通过剖宫产分娩（aOR 1.50，95% CI 1.34-1.68），并接受了充分的产前护理（aOR 1.93，95% CI 1.66-2.24）。有一致选择的女性更有可能选择高效的避孕方法（p < 0.001），更有可能实现避孕计划（校正比值比[aOR] 2.16，95%置信区间[95% CI] 1.85-2.52），但分娩后365天内再次妊娠的可能性并不更高（aOR 0.92，95% CI 0.81-1.05）。在我们的研究中，大多数妇女的产后避孕方法计划的有效性从产前到住院产后护理的变化。更好地理解避孕决策是一个过程，并在这一过程中消除外部障碍，是怀孕护理的必要组成部分。在产前和产后护理过程中咨询和记录避孕偏好有助于改善避孕效果。
To identify characteristics of women who have consistent plans in terms of contraceptive effectiveness from antepartum to postpartum care and whether consistency affects contraceptive outcomes. This is a secondary analysis of a retrospective chart review of women who delivered at a single tertiary care center from 2012–2014. Preferred postpartum contraceptive plan was abstracted at three time points (prenatal care, hospital discharge, and outpatient postpartum care) and categorized into three tiers of effectiveness. We then examined consistency between the first two time points for the effectiveness in postpartum contraceptive method planned. Of the 8,394 women in the study cohort, 2,642 (31.5%) had a consistent postpartum contraceptive tier planned at the first two time points. Women who had consistent contraceptive preferences were more likely to have higher parity (aOR 2.36, 95% CI 2.06–2.70 for parity 2+), delivered via cesarean section (aOR 1.50, 95% CI 1.34–1.68), and have received adequate prenatal care (aOR 1.93, 95% CI 1.66–2.24). Women who had a consistent choice were more likely to choose highly effective methods of contraception (p < 0.001) and more likely to achieve their contraception plan (adjusted odds ratio [aOR] 2.16, 95% confidence interval [95% CI] 1.85–2.52), but not more likely to have a subsequent pregnancy within 365 days of delivery (aOR 0.92, 95% CI 0.81–1.05). The majority of women in our study had variation in effectiveness of their postpartum contraceptive method plan from prenatal to inpatient postpartum care. Better understanding contraceptive decision-making as a journey and removing external barriers during that process is a necessary component of pregnancy care. Counseling and documentation of contraceptive preferences throughout antepartum and postpartum care can help improve contraceptive outcomes.
登录
查看更多内容
DOI：
10.1136/jfprhc-2014-101165
发表时间：
2016-04-01
影响因子：
--
作者：
Heller, Rebecca;Cameron, Sharon;Glasier, Anna
通讯作者：
Glasier, Anna
影响因子：
2.9
作者：
Wilkinson, Barbara;Ascha, Mustafa;Arora, Kavita Shah
通讯作者：
Arora, Kavita Shah
影响因子：
9.8
作者：
Madden, Tessa;Secura, Gina M.;Nease, Robert F.;Politi, Mary C.;Peipert, Jeffrey F.
通讯作者：
Peipert, Jeffrey F.
影响因子：
5.8
作者：
Higgins JA
通讯作者：
Higgins JA
影响因子：
2.5
作者：
Tibaijuka, Leevan;Odongo, Robert;Bajunirwe, Francis
通讯作者：
Bajunirwe, Francis