Anaemic women are more at risk of injectable contraceptive discontinuation due to side-effects in Ethiopia
Anaemic women are more at risk of injectable contraceptive discontinuation due to side-effects in Ethiopia
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在埃塞俄比亚，贫血女性因副作用而更容易停止注射避孕药
DOI：
10.1101/2020.10.28.20221523
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Stevens R
中科院分区：
文献类型：
--
作者：
Stevens R
本文调查了在埃塞俄比亚，妇女的生理状况以及社会文化因素对于预测因副作用而停用注射避孕药的风险的重要性。分析了2016年埃塞俄比亚人口与健康调查中的避孕日历数据。在过去两年中开始注射避孕药的15-49岁妇女被纳入分析(n=1,513)。调查的生理因素包括体重、铁状况、生殖衰竭和身体紧张。在检查反向因果关系后，生理和社会文化危险因素与因副作用而停药(DSE)或因其他原因停药(DOR)之间的关联通过多变量COX比例回归分析来评估。贫血状况与DSE相关，但与DOR无关。贫血妇女患DSE的风险是非贫血妇女的两倍(调整后的危险比[AHR]=2.38，可信区间[CI]=1.41-4.00)。DOR受宗教、财富和关系状况的影响。考虑到生理条件的多样性是理解因副作用而停止避孕的关键。为了减少副作用，计划生育计划可能受益于在解决贫血的综合方案中提供荷尔蒙避孕。
This paper investigates the importance of women's physiological condition, alongside sociocultural factors, for predicting the risk of discontinuation of the injectable contraceptive due to side effects in Ethiopia. Contraceptive calendar data from the 2016 Ethiopian Demographic and Health Survey were analyzed. Women aged 15–49 who had initiated the injectable contraceptive in the last two years were included in the analysis (n = 1,513). Physiological factors investigated were body mass, iron status, reproductive depletion, and physical strain. After checking for reverse causality, associations between physiological and sociocultural risk factors and discontinuation due to side effects (DSE) or discontinuation due to other reasons (DOR) were estimated using multivariate Cox proportional regression analyses. Anemia status was associated with DSE, but not DOR. Anemic women were two times more at risk of DSE compared with nonanemic women (adjusted hazard ratios [aHR] = 2.38, confidence interval [CI] = 1.41–4.00). DOR was predicted by religion, wealth, and relationship status. Accounting for diversity in physiological condition is key for understanding contraceptive discontinuation due to side effects. To reduce side effects, family planning programs might benefit from providing hormonal contraception within an integrated package addressing anemia.