Contraception utilization in women with pregestational diabetes

Abstract

Objective

To compare contraception use between women with and without pregestational diabetes.

Methods

Cross-sectional data on women aged 18–44 years from 2011 to 2017 National Survey of Family Growth (NSFG) was analysed. Maternal diabetes was defined as the presence of pre-gestational type 1 or type 2 diabetes. Bivariate and multiple logistic regression analyses were run to evaluate the association between the use of contraception and by contraception type: permanent, long-acting reversible contraception (LARC), other hormonal method, other non-hormonal method, and none, and maternal diabetes status, controlling for relevant covariates.

Results

Among the total study sample of 28,454, 1344 (4.7%) had pregestational diabetes. Unadjusted analysis showed women with a history of pregestational diabetes were more likely to use permanent contraception following pregnancy (58.0% vs. 38.7%, p < 0.001) or no contraception (27.2% vs. 24.5%, p < 0.001), but less likely to use LARC (3.4% vs. 11.7%, p < 0.001), other hormonal contraception (4.1% vs. 8.9%, p < 0.001), or other non-hormonal contraception (7.2% vs. 16.4%, p < 0.001). In adjusted analyses, permanent (aOR 1.62, 95% CI 0.72–2.26) remained significant, however the differences were no longer statistically significant: LARC (aOR 0.34, 95% CI 0.12–1.00); other hormonal (aOR 0.61, 95% CI 0.27–1.35); other non-hormonal (aOR 0.59, 95% CI 0.25–1.43); and None (aOR 1.11, 95% CI 0.65–1.89).

Conclusion

In this analysis, we found that women with pregestational diabetes were more likely to use permanent contraception methods compared to women without pregestational diabetes; however over a quarter of women with pregestational diabetes did not use contraception between pregnancies.

摘要

目的:比较妊娠前糖尿病妇女与非妊娠前糖尿病妇女采取避孕情况。

方法:对2011 - 2017年全国家庭增长调查(NSFG) 18-44岁女性的横断面数据进行分析。孕妇糖尿病被定义为存在妊娠前1型或2型糖尿病。采用双变量和多元逻辑回归分析评估避孕方法的应用与避孕方式：永久性、长效可逆避孕(LARC)、其他激素方法、其他非激素方法和无, 以及产妇糖尿病状况, 并控制相关协变量之间的关系。

结果:在28,454,1344例(4.7%)的研究样本中有妊娠前糖尿病。未经调整的分析显示, 有孕前糖尿病史的女性更有可能在怀孕后应用永久性避孕(58.0% vs. 38.7%, p < 0.001)。或未采取避孕措施(27.2% vs. 24.5%, p < 0.001), 但较少应用LARC (3.4% vs. 11.7%, p < 0.001), 其他激素避孕(4.1% vs. 8.9%, p < 0.001), 或其他非激素避孕(7.2% vs.16.4%, p < 0.001)。在调整后的分析中, 永久性(aOR 1.62, 95% CI 0.72-2.26)仍然显著, 但差异不再具有统计学意义:LARC (aOR 0.34, 95% CI 0.12-1.00);其他激素(aOR 0.61, 95% CI 0.27-1.35);其他非激素(aOR 0.59, 95% CI 0.25-1.43);无(aOR 1.11, 95% CI 0.65-1.89)。

结论:在这项分析中, 我们发现与非妊娠前糖尿病的女性相比, 妊娠前糖尿病女性更有可能应用永久性避孕方法;然而, 超过四分之一的孕前糖尿病的女性在妊娠的间期没有采取避孕措施。

Keywords:

• Contraceptive use
• diabetes
• pregnancy
• gestational diabetes
• women’s health

Acknowledgements

Presented at the American Diabetes Association’s 80th Scientific Sessions Virtual Meeting 12–16th June 2020.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Anna Palatnik is funded by NIH/NICHD (1R01HD108194-01). Leonard Egede is funded by NIMHD (5R01MD013826-04) and by NIDDK (5R01DK120861-04). The funding was received for other diabetes-related studies and not for this study.