Women with sickle cell disease report low knowledge and use of long acting reversible contraception.
Women with sickle cell disease report low knowledge and use of long acting reversible contraception.
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DOI：
10.1016/j.jnma.2021.05.005
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发表时间：
2021-10
影响因子：
3.3
通讯作者：
Whaley, Natalie
中科院分区：
文献类型：
--
作者：
Pecker, Lydia H.;Hussain, Sarah;Lanzkron, Sophie;Tao, Xueting;Thaler, Katrina;Burke, Anne E.;Whaley, Natalie
据报告，患有镰状细胞病 (SCD) 的女性意外怀孕率较高，避孕措施使用率较低。患有 SCD 的女性怀孕风险很高，意外怀孕限制了提供指定孕前护理和咨询的机会。由于缺乏有关治疗风险和益处的特定疾病数据，患有 SCD 的女性避孕措施的使用变得复杂。本研究的目的是首次在美国描述成年 SCD 女性的避孕药具使用情况、知识和偏好。对我们中心成人和儿童镰状细胞中心的育龄 SCD 女性进行的单中心调查研究。 78 名年龄在 28-65 岁之间的女性（中位年龄 33.5 岁，IQR 16）完成了调查。 73% 的受访者平均怀孕过 2.5 次（S.D. 1.22），其中 58% 的受访者表示自己至少在一次不想怀孕的情况下怀孕了。最常见的避孕方式是避孕套（87%）、避孕药（46%）、甲羟孕酮（44%）和戒断避孕（44%）。 22% 的受试者报告使用长效可逆避孕方式，21% 的受试者报告使用输卵管结扎或伴侣输精管切除术。受访者对避孕方法的功效了解甚少，并且高估了宫内节育器、植入物的妊娠风险。避孕重点包括预防怀孕、减少艾滋病毒传播以及对猝死症状的影响。患有SCD的女性意外怀孕率高，避孕功效知识低，长效可逆避孕药使用率低。
High rates of unplanned pregnancy and low rates of contraception use are reported among women with sickle cell disease (SCD). Pregnancy in women with SCD is high risk and unintended pregnancies limit opportunities to provide indicated preconception care and counseling. Contraceptive use in women with SCD is complicated by a lack of disease-specific data about treatment risks and benefits. The purpose of this study was to describe, for the first time in the U.S. context, contraceptive use, knowledge and preferences in adult cohort of women with SCD. A single-center survey study of women with SCD of reproductive age from our Center’s adult and pediatric sickle cell centers. Seventy-eight women ages 28–65 years (median 33.5 years, IQR 16) completed surveys. Seventy-three percent of respondents had an average of 2.5 pregnancies (S.D. 1.22) and of these, 58% reported being pregnant when they did not want to be pregnant at least once. The most common forms of contraception used were condoms (87%), birth control pills (46%), medroxyprogesterone (44%) and withdrawal (44%). Twenty-two percent of subjects reported using a long-acting reversible form of contraception and 21% reported a tubal ligation or partner vasectomy. Respondents demonstrated low knowledge of the efficacy of contraceptive options and over-estimated the risk of pregnancy with the IUD, implant. Contraceptive priorities included pregnancy prevention, decreasing HIV transmission and effects on SCD symptoms. Women with SCD have high rates of unintended pregnancy, low knowledge of contraceptive efficacy and low use of long-acting reversible contraception.
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