Family-planning practices among women with diabetes and overweight and obese women in the 2002 National Survey For Family Growth.
Family-planning practices among women with diabetes and overweight and obese women in the 2002 National Survey For Family Growth.
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DOI：
10.2337/dc08-2105
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发表时间：
2009-06
期刊：
影响因子：
16.2
通讯作者：
Kim C
中科院分区：
文献类型：
--
作者：
Vahratian A;Barber JS;Lawrence JM;Kim C
研究糖尿病妇女和肥胖妇女的避孕措施。我们分析了2002年全国家庭成长调查中年龄在20-44岁之间的5,955名参与者的回答。通过自我报告获得糖尿病、BMI、怀孕愿望、不孕症治疗史、性活动、产次和人口统计学变量（年龄、种族/民族、教育、婚姻状况、收入、保险和吸烟史）。缺乏避孕被定义为缺乏激素、屏障或绝育方法。避孕、糖尿病和BMI类别之间的关联在非不育、性活跃的女性中进行多变量logistic回归模型评估。在未绝育的性活跃女性中进行的未经调整的比较中，糖尿病女性比非糖尿病女性更可能缺乏避孕措施（比值比[OR] 2.61 [95%CI 1.22-5.58]）。BMI ≥35 kg/m2的女性比BMI <25 kg/m2的女性更可能缺乏避孕措施（1.63 [1.16-2.28]），但避孕措施的使用与较轻程度的超重和肥胖之间的相关性并不显著。在多变量模型中，年龄较大（≥30岁vs. 20-29岁）、非西班牙裔黑人、同居、有不孕症治疗史、希望怀孕或对怀孕有矛盾心理的女性更有可能缺乏避孕措施。在这些调整之后，糖尿病、BMI和避孕之间的关联不再显著。患有糖尿病和肥胖症的老年妇女希望怀孕，无论怀孕意图如何，都应该有针对性地进行孕前管理。
To examine contraceptive practices among diabetic women and obese women. We analyzed the responses of 5,955 participants aged 20–44 years in the 2002 National Survey for Family Growth. Diabetes, BMI, desire for pregnancy, history of infertility treatment, sexual activity, parity, and demographic variables (age, race/ethnicity, education, marital status, income, insurance, and smoking history) were obtained by self-report. Lack of contraception was defined as absence of hormonal-, barrier-, or sterilization-based methods. Associations among contraception, diabetes, and BMI category were assessed in multivariable logistic regression models in nonsterile, sexually active women. In unadjusted comparisons among sexually active women who were not sterilized, women with diabetes were more likely to lack contraception than women without diabetes (odds ratio [OR] 2.61 [95% CI 1.22–5.58]). Women with BMI ≥35 kg/m2 were more likely to lack contraception than women with BMI <25 kg/m2(1.63 [1.16–2.28]), but associations between contraception use and lesser degrees of overweight and obesity were not significant. In multivariable models, women who were older (aged ≥30 vs. 20–29 years), were of non-Hispanic black race, were cohabitating, had a history of infertility treatment, and desired or were ambivalent about pregnancy were significantly more likely to lack contraception. The associations among diabetes, BMI, and contraception were no longer significant after these adjustments. Older women with diabetes and obesity who desire pregnancy, regardless of pregnancy intention, should be targeted for preconceptive management.
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