背景:鉴于年轻女性的慢性病正在增加,这些女性的意外怀孕与不良的母婴结局有关,这些妇女将受益于有效的孕前保健。然而,人们对这些妇女如何使用或不使用避孕药来告知这些干预措施缺乏了解。这项研究调查了澳大利亚年轻女性队列中避孕药具的使用模式,并调查了慢性病对避孕药具使用的影响。
方法:使用来自澳大利亚妇女健康纵向研究(1989-1995年出生)的15,244名年轻女性的数据,我们进行了潜在过渡分析,以确定有意外怀孕风险的女性中不同的避孕模式.使用多项混合效应模型来评估避孕组合与慢性病之间的关系。
结果:在观察期间,患有心脏和自身炎性疾病的女性使用避孕药与没有慢性疾病的女性不同。与没有慢性疾病的女性使用避孕药相比,患有心脏病的女性使用其他避孕药和避孕套的几率增加了一倍(OR=2.20,95%CI1.34,3.59),使用口服避孕药和避孕套的几率略有增加(OR=1.39,95%CI1.03,1.89).与使用避孕药的没有慢性病的女性相比,患有自身炎性疾病的女性使用LARC和避孕套的几率增加(OR=1.58,95%CI1.04,2.41),使用“其他”避孕和避孕套(OR=1.69,95%CI1.11,2.57),并联合使用口服避孕药和避孕套(OR=1.38,95%CI1.09,1.75)。与没有慢性病的女性相比,患有哮喘或糖尿病的女性在观察期间的避孕方式没有差异。
结论:研究发现,作为常规慢性病护理的一部分,需要有效的避孕咨询,并改善卫生保健提供者与慢性病妇女之间的沟通,以提高年轻妇女的避孕知识和避孕机构选择,特别是对于那些患有心脏或自身炎症的人。这可能是减少这一弱势群体中高风险意外怀孕的关键。
慢性疾病在年轻女性中正在增加,这些女性的意外怀孕与母亲和婴儿的不良结局有关。为了优化结果,对于这些妇女来说,重要的是计划怀孕并在这段时间之前使用有效的避孕方法。然而,对这些妇女如何使用或不使用避孕药缺乏了解,特别是在高效避孕方面。这项研究调查了澳大利亚年轻女性队列(1989-1995年出生)中避孕药具的使用方式,并调查了慢性病对避孕药具使用的影响。我们发现,随着时间的推移,患有心脏病的女性和患有自身炎性疾病的女性使用避孕药具的差异。重要的是,与没有慢性疾病的女性相比,仅使用避孕药,患有心脏病的女性使用低疗效避孕的可能性增加了一倍.虽然患有自身炎性疾病的女性使用长效方法结合避孕套的可能性增加了69%,这些女性使用低功效避孕的可能性也增加了70%,与仅使用避孕药的无慢性病女性相比。患有哮喘或糖尿病的女性与没有慢性疾病的女性的避孕方式没有差异。调查结果确定,作为常规慢性病护理的一部分,需要有效的避孕咨询,并改善医疗保健提供者与慢性病妇女之间的沟通,以提高年轻妇女的避孕知识和避孕决策,特别是对于那些患有心脏或自身炎症的人。这可能是减少这一弱势群体中高风险意外怀孕的关键。
BACKGROUND: Given chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor maternal and fetal outcomes, these women would benefit from effective preconception care. However, there is a lack of understanding of how these women use or don\'t use contraception to inform such interventions. This
study examined patterns of contraceptive use among an Australian cohort of young women and investigated the influence of chronic disease on contraceptive use over time.
METHODS: Using data from 15,244 young women from the Australian Longitudinal
Study on Women\'s Health (born 1989-1995), latent transition analysis was performed to identify distinct contraceptive patterns among women who were at risk of an unintended pregnancy. Multinomial mixed-effect models were used to evaluate the relationship between contraceptive combinations and chronic disease.
RESULTS: Contraceptive use for women with cardiac and autoinflammatory diseases differed to women without chronic disease over the observation period. Compared to women without chronic disease using the pill, women with cardiac disease had double the odds of using \'other\' contraception and condoms (OR = 2.20, 95% CI 1.34, 3.59) and a modest increase in the odds of using the combined oral contraceptive pill and condoms (OR = 1.39, 95% CI 1.03, 1.89). Compared to women without chronic disease who used the pill, women with autoinflammatory disease had increased odds of using LARC and condoms (OR = 1.58, 95% CI 1.04, 2.41), using \'other\' contraception and condoms (OR = 1.69, 95% CI 1.11, 2.57), and using the combined oral contraceptive pill and condoms (OR = 1.38, 95% CI 1.09, 1.75). No differences in contraceptive patterns over the observation period were found for women with asthma or diabetes when compared to women without chronic disease.
CONCLUSIONS: The findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between health care providers and women with chronic disease to improve young women\'s contraceptive knowledge and agency in contraceptive choice, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.
Chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor outcomes for both the mother and baby. To optimise outcomes, it is important for these women to plan pregnancies and use effective contraception until such time. However, there is a lack of understanding of how these women use or don’t use contraception, particularly with respect to highly effective contraception. This
study examined patterns of contraceptive use among an Australian cohort of young women (born 1989–1995) and investigated the influence of chronic disease on contraceptive use over time. We found differences in contraceptive use over time for women with cardiac disease and those with autoinflammatory diseases. Importantly, compared to women without chronic disease using the pill alone, women with cardiac disease had double the odds of using low efficacy contraception. While women with autoinflammatory disease were 69% more likely to use long-acting methods combined with condoms, these women were also 70% more likely to use low efficacy contraception, compared to women without chronic disease who used the pill only. Contraceptive patterns did not differ for women with asthma or diabetes from women without chronic disease. The findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between health care providers and women with chronic disease to improve young women’s contraceptive knowledge and contraceptive decision-making, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.