Association Between Comorbidities and Inpatient Postpartum Permanent Contraception Completion

Area of Science:

• Reproductive Health
• Maternal-Fetal Medicine
• Surgical Outcomes

Background:

• Postpartum permanent contraception via tubal surgery is a desired family planning method.
• Understanding factors influencing completion rates, such as comorbidities, is essential for patient care.
• Comorbidities encompass both pre-existing medical conditions and peripartum complications.

Purpose of the Study:

• To investigate the association between comorbidities and the completion of inpatient postpartum permanent contraception by tubal surgery.
• To determine if medical conditions or peripartum complications affect the likelihood of achieving postpartum permanent contraception.

Main Methods:

• Secondary analysis of a multisite retrospective cohort study.
• Included patients with documented plans for permanent contraception.
• Utilized logistic regression to analyze associations between comorbidities and tubal surgery completion.

Main Results:

• 53.4% of patients completed postpartum permanent contraception by discharge; 70.8% had comorbidities.
• No statistically significant association was found between aggregate comorbidities (medical conditions or peripartum complications) and contraception completion after adjusting for multiple comparisons.
• Individual comorbidities like hypertension, mental health diagnoses, and elevated BMI (≥40) also showed no significant impact on completion rates.

Conclusions:

• Medical comorbidities did not demonstrate a statistically significant effect on inpatient postpartum permanent contraception attainment in this cohort.
• While no significant impact was observed, mitigating modifiable barriers to desired permanent contraception is imperative.
• Further research is recommended to fully understand the complex interplay between medical comorbidities and contraception choices.