Postpartum contraceptive use among women with a recent preterm birth

Details

• Alternative Title:
  Am J Obstet Gynecol
• Personal Author:
  ROBBINS, Cheryl L. ; FARR, Sherry L. ; ZAPATA, Lauren B. ; D’ANGELO, Denise V. ; CALLAGHAN, William M.
• Description:
  OBJECTIVE
  
  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 nine states were used to estimate 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 differences in contraception by gestational age (≤27, 28–33, or 34–36 weeks versus 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 decreased odds of using highly or moderately effective methods (adjusted odds ratio [aOR]=0.5, 95% confidence interval [CI]: 0.4 – 0.6) and user-independent methods (aOR=0.5, 95% CI: 0.4 – 0.7) compared with women having term births. Wanting to get pregnant was more frequently reported as a reason for contraceptive non-use 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 over half (54%) of these mothers reported wanting to become pregnant as the reason for contraceptive non-use.
  
  CONCLUSIONS
  
  During contraceptive counseling with women who had recent preterm births, providers should address 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.
  
  
• Subjects:
  Adolescent Adult Birth Intervals Cohort Studies Contraception Behavior Contraceptive Agents, Female Contraceptive Devices, Female Contraceptives, Oral Drug Implants Female Gestational Age Humans Infant Infant, Newborn Insurance, Health Intrauterine Devices Logistic Models Medicaid Multivariate Analysis Perinatal Death Postpartum Period Pregnancy Premature Birth Retrospective Studies Sterilization, Reproductive United States Young Adult

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• Keywords:
  Contraception Effectiveness Insurance Postpartum Preterm Birth
• Source:
  Am J Obstet Gynecol. 213(4):508.e1-508.e9
• Pubmed ID:
  26003062
• Pubmed Central ID:
  PMC5379122
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  213
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:557e75891f861cd7b947b29015660a51c2c57c69b7f23758d781376043f4a23d
• Download URL:
  https://stacks.cdc.gov/view/cdc/45002/cdc_45002_DS1.pdf
• File Type:
  [PDF - 260.45 KB ]