Contraceptive use by diabetic and obese women
Contraceptive use by diabetic and obese women
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DOI：
10.1016/j.whi.2005.04.002
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发表时间：
2005-07-01
影响因子：
3.2
通讯作者：
Weisman, CS
中科院分区：
文献类型：
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作者：
Chuang, CH;Chase, GA;Weisman, CS
目的：患有慢性疾病的妇女发生不良妊娠结局的风险增加，但这些妇女使用避孕药具的情况尚未得到很好的描述。本研究的目的是描述糖尿病和超重/肥胖妇女与无这些条件的妇女相比避孕的使用情况。使用2000年参与行为风险因素监测系统可选计划生育模块的11个州的横截面数据，我们分析了7个州，943名育龄期（18-44岁）性活跃的女性，她们没有试图怀孕。使用逻辑回归技术，我们模拟了糖尿病和超重/肥胖对不使用避孕药具的影响，控制了年龄，种族/民族，婚姻状况，教育，收入和健康保险覆盖范围。主要发现：总样本中有1 500人（18.9%）报告未使用避孕药具，其中31人（25.8%）为糖尿病妇女，371人（20.0%）为超重妇女，385人（23.4%）为肥胖妇女。在多变量模型中，肥胖与不使用避孕措施显著相关（调整后的比值比[OR] 1.34，95%可信区间[CI] 1.16-1.55），但糖尿病女性不使用避孕药无显著差异（调整OR 1.23，95% CI 0.80-1.87）或超重女性（调整OR 1.14，95% CI 0.99-1.31）。老年人，黑人，西班牙裔，已婚，受教育程度较低，没有健康保险的妇女更有可能报告避孕nonuse.Conclusion：在妇女需要避孕，肥胖的妇女更有可能报告避孕nonuse比正常体重的妇女。由于患有肥胖等慢性疾病的妇女患妊娠相关并发症和不良妊娠结局的风险更高，因此应优先考虑正确使用避孕药具和避免意外怀孕。
Purpose: Women with chronic medical conditions are at increased risk for adverse pregnancy outcomes, yet contraceptive use by these women has not been well described. The purpose of this study was to describe contraceptive use by diabetic and overweight/obese women compared with women without these conditions.Methods: Using cross-sectional data from the 11 states participating in the optional Family Planning Module of the Behavioral Risk Factor Surveillance System in 2000, we analyzed contraceptive use among 7,943 sexually active women of reproductive age (18-44) who were not trying to conceive. Using logistic regression techniques, we modeled the effect of diabetes and overweight/obesity on contraceptive nonuse, controlling for age, race/ethnicity, marital status, education, income, and health insurance coverage.Main Findings: Contraceptive nonuse was reported by 1,500 (18.9%) of the total sample, 31 (25.8%) diabetic women, 371 (20.0%) overweight women, and 385 (23.4%) obese women. In the multivariable model, obesity was significantly associated with contraceptive nonuse (adjusted odds ratio [OR] 1.34, 95% confidence interval [CI] 1.16-1.55), but there were no significant differences in contraceptive nonuse for diabetic women (adjusted OR 1.23, 95% CI 0.80-1.87) or overweight women (adjusted OR 1.14, 95% CI 0.99-1.31). Older, Black, Hispanic, married, less educated, and women without health insurance were more likely to report contraceptive nonuse.Conclusion: Among women with need for contraception, obese women were more likely to report contraceptive nonuse than normal weight women. Because women with chronic conditions like obesity are at higher risk of pregnancy-related complications and adverse pregnancy outcomes, proper contraceptive use and unintended pregnancy avoidance is a priority.