Nonfulfillment of desired postpartum permanent contraception and resultant maternal and pregnancy health outcomes.
disparity
maternal health
postpartum contraception
short interpregnancy interval
sterilization
Journal
AJOG global reports
ISSN: 2666-5778
Titre abrégé: AJOG Glob Rep
Pays: United States
ID NLM: 101777907
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
entrez:
19
1
2023
pubmed:
20
1
2023
medline:
20
1
2023
Statut:
epublish
Résumé
Up to half of the patients requesting postpartum permanent contraception do not undergo the desired procedure. Although nonfulfillment of desired postpartum permanent contraception is associated with increased risk of pregnancy within 12 months of delivery, its long-term reproductive and maternal health outcomes are less clear. This study aimed to determine the association of fulfillment of postpartum permanent contraception with number and timing of subsequent pregnancies and maternal health outcomes. This was a retrospective single-center cohort chart review study of health outcomes in the 4 years following delivery (2016-2018) for 1331 patients with a documented contraceptive plan of female permanent contraception at time of postpartum discharge from 2012 to 2014. Rates of permanent contraception fulfillment within 90 days of delivery and clinical and demographic characteristics associated with permanent contraception were calculated. We determined number of and time to subsequent pregnancies, and diagnoses of medical comorbidities (hypertension, diabetes mellitus, depression, anxiety, asthma, anemia), sexually transmitted infection, and pregnancy comorbidities (preterm birth, gestational diabetes mellitus, gestational hypertension, preeclampsia, postpartum hemorrhage, low birthweight, intrauterine fetal demise) in the 4 years following delivery. Of the 1331 patients desiring permanent contraception postpartum, 588 (44.1%) had their requests fulfilled within 90 days of delivery and 743 (55.8%) did not. Patients who achieved permanent contraception fulfillment tended to have attended more outpatient prenatal visits, delivered via cesarean delivery, and were older, married, college-educated, and privately insured. Patients who received their desired postpartum permanent contraception were less likely to have subsequent intrauterine pregnancies ( Nonfulfillment of desired postpartum permanent contraception is associated with subsequent maternal reproductive and nonreproductive health ramifications. Given the barriers to permanent contraception, alternative plans for contraception should be discussed proactively if permanent contraception is not provided.
Sections du résumé
BACKGROUND
BACKGROUND
Up to half of the patients requesting postpartum permanent contraception do not undergo the desired procedure. Although nonfulfillment of desired postpartum permanent contraception is associated with increased risk of pregnancy within 12 months of delivery, its long-term reproductive and maternal health outcomes are less clear.
OBJECTIVE
OBJECTIVE
This study aimed to determine the association of fulfillment of postpartum permanent contraception with number and timing of subsequent pregnancies and maternal health outcomes.
STUDY DESIGN
METHODS
This was a retrospective single-center cohort chart review study of health outcomes in the 4 years following delivery (2016-2018) for 1331 patients with a documented contraceptive plan of female permanent contraception at time of postpartum discharge from 2012 to 2014. Rates of permanent contraception fulfillment within 90 days of delivery and clinical and demographic characteristics associated with permanent contraception were calculated. We determined number of and time to subsequent pregnancies, and diagnoses of medical comorbidities (hypertension, diabetes mellitus, depression, anxiety, asthma, anemia), sexually transmitted infection, and pregnancy comorbidities (preterm birth, gestational diabetes mellitus, gestational hypertension, preeclampsia, postpartum hemorrhage, low birthweight, intrauterine fetal demise) in the 4 years following delivery.
RESULTS
RESULTS
Of the 1331 patients desiring permanent contraception postpartum, 588 (44.1%) had their requests fulfilled within 90 days of delivery and 743 (55.8%) did not. Patients who achieved permanent contraception fulfillment tended to have attended more outpatient prenatal visits, delivered via cesarean delivery, and were older, married, college-educated, and privately insured. Patients who received their desired postpartum permanent contraception were less likely to have subsequent intrauterine pregnancies (
CONCLUSION
CONCLUSIONS
Nonfulfillment of desired postpartum permanent contraception is associated with subsequent maternal reproductive and nonreproductive health ramifications. Given the barriers to permanent contraception, alternative plans for contraception should be discussed proactively if permanent contraception is not provided.
Identifiants
pubmed: 36655168
doi: 10.1016/j.xagr.2022.100151
pii: S2666-5778(22)00099-5
pmc: PMC9841276
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100151Informations de copyright
© 2022 The Authors.
Références
Int J Womens Health. 2018 Aug 13;10:425-429
pubmed: 30147379
Obstet Gynecol. 2015 Jun;125(6):1471-1477
pubmed: 26000519
NCHS Data Brief. 2020 Oct;(388):1-8
pubmed: 33151146
Contraception. 2006 Apr;73(4):404-7
pubmed: 16531176
Contraception. 2014 Jun;89(6):487-8
pubmed: 24815100
Health Equity. 2020 Jul 17;4(1):326-329
pubmed: 32775942
Contraception. 2017 Oct;96(4):221-226
pubmed: 28756187
Am J Obstet Gynecol. 2015 Feb;212(2):171.e1-8
pubmed: 25093946
Am J Obstet Gynecol. 2010 Oct;203(4):319.e1-8
pubmed: 20598282
J Health Care Poor Underserved. 2011 Nov;22(4):1387-400
pubmed: 22080717
Contraception. 2013 Dec;88(6):691-6
pubmed: 24028751
Am J Public Health. 2012 Oct;102(10):1822-5
pubmed: 22897531
Contraception. 2020 Nov;102(5):376-382
pubmed: 32858053
Obstet Gynecol. 2010 Nov;116(5):1071-7
pubmed: 20966691
Lancet. 2012 Jul 14;380(9837):149-56
pubmed: 22784533
Contraception. 2020 Nov;102(5):368-375
pubmed: 32739505
Obstet Gynecol. 2016 Feb;127(2):e66-9
pubmed: 26942389
Obstet Gynecol. 2019 Jan;133(1):e51-e72
pubmed: 30575677
Am J Obstet Gynecol. 2014 Apr;210(4):311.e1-311.e8
pubmed: 24334205
Obstet Gynecol. 2019 Dec;134(6):1178-1185
pubmed: 31764727
N Engl J Med. 2014 Jan 9;370(2):102-4
pubmed: 24401047
Contraception. 2018 Jun;97(6):559-564
pubmed: 29490290
Am J Obstet Gynecol. 2018 Jan;218(1):140-141
pubmed: 28888588
Clin Obstet Gynecol. 2015 Jun;58(2):409-17
pubmed: 25811128