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Postpartum contraceptive use among women with a recent preterm birth.
Am J Obstet Gynecol 2015; 213(4):508.e1-9AJ

Abstract

OBJECTIVE

The objective of the study was to evaluate the associations between postpartum contraception and having a recent preterm birth.

STUDY DESIGN

Population-based data from the Pregnancy Risk Assessment Monitoring System in 9 states were used to estimate the postpartum use of highly or moderately effective contraception (sterilization, intrauterine device, implants, shots, pills, patch, and ring) and user-independent contraception (sterilization, implants, and intrauterine device) among women with recent live births (2009-2011). We assessed the differences in contraception by gestational age (≤27, 28-33, or 34-36 weeks vs term [≥37 weeks]) and modeled the associations using multivariable logistic regression with weighted data.

RESULTS

A higher percentage of women with recent extreme preterm birth (≤27 weeks) reported using no postpartum method (31%) compared with all other women (15-16%). Women delivering extreme preterm infants had a decreased odds of using highly or moderately effective methods (adjusted odds ratio, 0.5; 95% confidence interval, 0.4-0.6) and user-independent methods (adjusted odds ratio, 0.5; 95% confidence interval, 0.4-0.7) compared with women having term births. Wanting to get pregnant was more frequently reported as a reason for contraceptive nonuse by women with an extreme preterm birth overall (45%) compared with all other women (15-18%, P < .0001). Infant death occurred in 41% of extreme preterm births and more than half of these mothers (54%) reported wanting to become pregnant as the reason for contraceptive nonuse.

CONCLUSION

During contraceptive counseling with women who had recent preterm births, providers should address an optimal pregnancy interval and consider that women with recent extreme preterm birth, particularly those whose infants died, may not use contraception because they want to get pregnant.

Authors+Show Affiliations

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: ggf9@cdc.gov.Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26003062

Citation

Robbins, Cheryl L., et al. "Postpartum Contraceptive Use Among Women With a Recent Preterm Birth." American Journal of Obstetrics and Gynecology, vol. 213, no. 4, 2015, pp. 508.e1-9.
Robbins CL, Farr SL, Zapata LB, et al. Postpartum contraceptive use among women with a recent preterm birth. Am J Obstet Gynecol. 2015;213(4):508.e1-9.
Robbins, C. L., Farr, S. L., Zapata, L. B., D'Angelo, D. V., & Callaghan, W. M. (2015). Postpartum contraceptive use among women with a recent preterm birth. American Journal of Obstetrics and Gynecology, 213(4), pp. 508.e1-9. doi:10.1016/j.ajog.2015.05.033.
Robbins CL, et al. Postpartum Contraceptive Use Among Women With a Recent Preterm Birth. Am J Obstet Gynecol. 2015;213(4):508.e1-9. PubMed PMID: 26003062.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postpartum contraceptive use among women with a recent preterm birth. AU - Robbins,Cheryl L, AU - Farr,Sherry L, AU - Zapata,Lauren B, AU - D'Angelo,Denise V, AU - Callaghan,William M, Y1 - 2015/05/21/ PY - 2015/03/10/received PY - 2015/04/20/revised PY - 2015/05/17/accepted PY - 2015/5/25/entrez PY - 2015/5/25/pubmed PY - 2015/12/29/medline KW - Medicaid KW - contraception effectiveness KW - insurance KW - postpartum KW - preterm birth SP - 508.e1 EP - 9 JF - American journal of obstetrics and gynecology JO - Am. J. Obstet. Gynecol. VL - 213 IS - 4 N2 - OBJECTIVE: The objective of the study was to evaluate the associations between postpartum contraception and having a recent preterm birth. STUDY DESIGN: Population-based data from the Pregnancy Risk Assessment Monitoring System in 9 states were used to estimate the postpartum use of highly or moderately effective contraception (sterilization, intrauterine device, implants, shots, pills, patch, and ring) and user-independent contraception (sterilization, implants, and intrauterine device) among women with recent live births (2009-2011). We assessed the differences in contraception by gestational age (≤27, 28-33, or 34-36 weeks vs term [≥37 weeks]) and modeled the associations using multivariable logistic regression with weighted data. RESULTS: A higher percentage of women with recent extreme preterm birth (≤27 weeks) reported using no postpartum method (31%) compared with all other women (15-16%). Women delivering extreme preterm infants had a decreased odds of using highly or moderately effective methods (adjusted odds ratio, 0.5; 95% confidence interval, 0.4-0.6) and user-independent methods (adjusted odds ratio, 0.5; 95% confidence interval, 0.4-0.7) compared with women having term births. Wanting to get pregnant was more frequently reported as a reason for contraceptive nonuse by women with an extreme preterm birth overall (45%) compared with all other women (15-18%, P < .0001). Infant death occurred in 41% of extreme preterm births and more than half of these mothers (54%) reported wanting to become pregnant as the reason for contraceptive nonuse. CONCLUSION: During contraceptive counseling with women who had recent preterm births, providers should address an optimal pregnancy interval and consider that women with recent extreme preterm birth, particularly those whose infants died, may not use contraception because they want to get pregnant. SN - 1097-6868 UR - https://www.unboundmedicine.com/medline/citation/26003062/Postpartum_contraceptive_use_among_women_with_a_recent_preterm_birth_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(15)00509-8 DB - PRIME DP - Unbound Medicine ER -