Sexual and reproductive health experiences and care of adult women with cystic fibrosis.


Journal

Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society
ISSN: 1873-5010
Titre abrégé: J Cyst Fibros
Pays: Netherlands
ID NLM: 101128966

Informations de publication

Date de publication:
03 2023
Historique:
received: 11 07 2022
revised: 18 08 2022
accepted: 28 09 2022
medline: 1 5 2023
pubmed: 10 10 2022
entrez: 9 10 2022
Statut: ppublish

Résumé

As survival and health improve in people with cystic fibrosis (CF), more women with CF (wwCF) are considering their sexual and reproductive health (SRH). This study compared SRH experiences, behaviors, and care utilization of wwCF to the general population and defined CF-impacted considerations and care preferences. We surveyed wwCF aged ≥25 years regarding SRH and compared results to the US National Survey of Family Growth (NSFG;n = 4357) and friend controls(n = 123). We used descriptive statistics and chi-squared/Fisher's exact testing and linear regression for comparisons. A total of 460 wwCF (mean age 36.1 years) completed the survey. WwCF were less likely to report current contraceptive use (43%vs76% NSFG, p<0.001;60% friends, p = 0.005). Nearly 25% of wwCF reported worsened CF symptoms during their menstrual cycles, 50% experienced urinary incontinence, and 80% vulvovaginal candidiasis. WwCF were significantly less likely to be parents (46%vs62% friends, p = 0.015) and to have experienced pregnancy (37%vs78% NSFG, p<0.001;58% friends, p = 0.002). More wwCF required medical assistance to conceive (29%vs12% NSFG, p<0.001 and 5% friends, p<0.001). Eighty-four percent of wwCF view their CF doctor as their main physician and 41% report no primary care provider (vs19% friends; p<0.001). WwCF report suboptimal rates of contraceptive and preconception counseling/care and are less likely to have received HPV vaccination (42%vs55%friends, p = 0.02). Despite desiring SRH conversations with their CF team, <50% report discussing SRH topics. WwCF have significantly different SRH experiences than non-CF peers. They report suboptimal SRH care compared to their preferences highlighting an urgent need to encourage SRH counseling/care in the CF model.

Sections du résumé

BACKGROUND
As survival and health improve in people with cystic fibrosis (CF), more women with CF (wwCF) are considering their sexual and reproductive health (SRH). This study compared SRH experiences, behaviors, and care utilization of wwCF to the general population and defined CF-impacted considerations and care preferences.
METHODS
We surveyed wwCF aged ≥25 years regarding SRH and compared results to the US National Survey of Family Growth (NSFG;n = 4357) and friend controls(n = 123). We used descriptive statistics and chi-squared/Fisher's exact testing and linear regression for comparisons.
RESULTS
A total of 460 wwCF (mean age 36.1 years) completed the survey. WwCF were less likely to report current contraceptive use (43%vs76% NSFG, p<0.001;60% friends, p = 0.005). Nearly 25% of wwCF reported worsened CF symptoms during their menstrual cycles, 50% experienced urinary incontinence, and 80% vulvovaginal candidiasis. WwCF were significantly less likely to be parents (46%vs62% friends, p = 0.015) and to have experienced pregnancy (37%vs78% NSFG, p<0.001;58% friends, p = 0.002). More wwCF required medical assistance to conceive (29%vs12% NSFG, p<0.001 and 5% friends, p<0.001). Eighty-four percent of wwCF view their CF doctor as their main physician and 41% report no primary care provider (vs19% friends; p<0.001). WwCF report suboptimal rates of contraceptive and preconception counseling/care and are less likely to have received HPV vaccination (42%vs55%friends, p = 0.02). Despite desiring SRH conversations with their CF team, <50% report discussing SRH topics.
CONCLUSION
WwCF have significantly different SRH experiences than non-CF peers. They report suboptimal SRH care compared to their preferences highlighting an urgent need to encourage SRH counseling/care in the CF model.

Identifiants

pubmed: 36210323
pii: S1569-1993(22)00690-7
doi: 10.1016/j.jcf.2022.09.013
pii:
doi:

Substances chimiques

Contraceptive Agents 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

223-233

Informations de copyright

Copyright © 2022. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors have no conflicts of interest to disclose related to this work. This study was funded by the Cystic Fibrosis Foundation (KAZMER18A0).|

Auteurs

Traci M Kazmerski (TM)

Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, PA; 230 McKee Place Pittsburgh, Pittsburgh, PA 15213, United States. Electronic address: traci.kazmerski@chp.edu.

Olivia M Stransky (OM)

Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, PA; 230 McKee Place Pittsburgh, Pittsburgh, PA 15213, United States.

Daniel R Lavage (DR)

Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.

Jennifer L Taylor-Cousar (JL)

National Jewish Health, Denver, CO; 1400 Jackson Street, Denver, CO J318, United States.

Gregory S Sawicki (GS)

Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, United States.

Sigrid L Ladores (SL)

School of Nursing, The University of Alabama at Birmingham, 1720 S. 2nd Ave., NB485-A, Birmingham, AL 35294, United States.

Emily M Godfrey (EM)

University of Washington, Box354982, 4311 11th Ave NE, Seattle WA 98105, United States.

Moira L Aitken (ML)

University of Washington, Box354982, 4311 11th Ave NE, Seattle WA 98105, United States.

Alana Fields (A)

Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.

Sandra Sufian (S)

University of Illinois-Chicago, 5001N. Wolcott Ave. #205 Chicago, IL 60640, United States.

Manu Jain (M)

Feinberg School of Medicine, Northwestern University, 303 E. Superior Street, SQ 5-526, Chicago, IL 60611, United States.

Tara L Barto (TL)

Baylor College of Medicine, 6620 Main St Suite 1225, Houston, TX 77030, United States.

Joanne Billings (J)

University of Minnesota, Minneapolis, MN 420 Delaware St. SE MMC 276 Minneapolis, MN 55455, United States.

Denis Hadjiliadis (D)

Department of Medicine, Perelman School of Medicine University of Pennsylvania, Division of Pulmonary, Allergy and Critical Care, 9031A W Gates Building, 3400 Spruce Street, Philadelphia 19104, United States.

Raksha Jain (R)

University of Texas Southwestern, 5323 Harry Hines Blvd., Dallas, TX 75390-8558, United States.

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