Related Experiment Video
Updated: Apr 20, 2026
14:43
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
13.8K
Strategies for improving postpartum contraceptive use: evidence from non-randomized studies
Laureen M Lopez1, Thomas W Grey, Mario Chen
1Clinical and Epidemiological Sciences, FHI 360, 359 Blackwell St, Suite 200, Durham, North Carolina, USA, 27701.
The Cochrane Database of Systematic Reviews
|November 28, 2014
Summary
Educational interventions show promise in improving postpartum contraceptive use and reducing subsequent pregnancies among women. However, the evidence quality is very low due to study limitations.
Area of Science:
- Public Health
- Reproductive Health
- Evidence-Based Medicine
Background:
- A significant unmet need for family planning exists in the first postpartum year, particularly for adolescents at risk of repeat pregnancies.
- Postpartum contraceptive counseling is provided, but decisions made immediately after may not reflect actual postpartum use.
- Previous randomized trials showed limited effectiveness of postpartum contraceptive counseling.
Purpose of the Study:
- To review non-randomized studies evaluating educational strategies aimed at enhancing postpartum contraceptive use.
- To investigate the association between specific interventions and improved postpartum contraceptive uptake or reduced subsequent pregnancies.
Main Methods:
- Searched for comparative non-randomized studies published up to November 3, 2014, across multiple databases.
- Included studies with an educational intervention (counseling or behavioral strategy) delivered within six weeks postpartum.
- Extracted data and computed odds ratios (OR) and mean differences (MD) with 95% Confidence Intervals (CI); assessed evidence quality using the Newcastle-Ottawa Scale.
Main Results:
- Six studies involving 5143 women were included. Two studies indicated a reduced likelihood of pregnancy in intervention groups (OR 0.48, 0.60).
- All studies showed a positive association between interventions and contraceptive use. Higher odds of using modern methods (OR 1.77, 3.08), pills (OR 1.78), or intrauterine devices (IUDs) (OR 3.72, 1.79) were observed.
- One study showed higher method-effectiveness scores (MD 13.26) and increased use of the lactational amenorrhea method (LAM) (OR 41.36) in intervention groups.
Conclusions:
- The overall quality of evidence was rated as very low due to significant limitations in study design, analysis, and reporting.
- Key limitations included lack of adjustment for confounding, insufficient intervention fidelity data, self-reported outcomes, and varied definitions of contraceptive use.
- Despite limitations, findings suggest educational interventions may positively influence postpartum contraceptive use and reduce pregnancy rates.
Related Concept Videos
01:22Birth Control Methods
7.4K
Vasectomy is a surgical form of male sterilization that involves severing and sealing the vasa deferentia, preventing sperm from mixing with semen during ejaculation. Because a vasectomy does not impact the testes' ability to produce testosterone, hormone levels, libido, and sexual function generally remain unchanged. While vasectomy is highly effective in preventing pregnancy, with a success rate near 99.85%, rare cases of recanalization (spontaneous reconnection) can occur. Although...
7.4K
01:21Intrauterine Drug Delivery Systems
155
Controlled-release systems for intravaginal and intrauterine drug delivery have been developed primarily for the administration of contraceptive steroid hormones. These delivery routes circumvent first-pass hepatic metabolism, thereby enhancing bioavailability and allowing for reduced systemic dosages compared to oral administration. Such approaches contribute to improved therapeutic efficacy and patient compliance, particularly in long-term contraceptive regimens.Intravaginal Drug Delivery...
155
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
587
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
587
01:25Strategies for Assessing and Addressing Confounding
582
Confounding is a critical issue in epidemiological studies, often leading to misleading conclusions about associations between exposures and outcomes. It occurs when the relationship between the exposure and the outcome is mixed with the effects of other factors that influence the outcome. Given that, addressing confounding is of high importance for drawing accurate inferences in research.
Confounding can be addressed at both the design phase of a study and through analytical methods after data...
Confounding can be addressed at both the design phase of a study and through analytical methods after data...
582
01:26Oral Drug Delivery Systems: Continuous-Release Systems
273
Continuous-release drug delivery systems offer a strategic approach to maintaining therapeutic drug levels over extended periods following oral administration. By modulating the release rate of active pharmaceutical ingredients, these systems minimize fluctuations in plasma concentrations, which enhances clinical efficacy and reduces the need for frequent dosing. Such characteristics make them particularly advantageous in managing chronic diseases where patient adherence and stable drug...
273
01:28Dosage Regimens: Designs and Approaches
576
Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
576