Contraceptive use in women of childbearing age with bipolar disorder

Unplanned pregnancies are frequent in women with bipolar disorder (BD) while perinatal period is associated with a higher risk of relapse. Effective contraception during childbearing age in BD could reduce the risk of unplanned pregnancy and its consequences. The present study studied the prevalence of contraceptive use and which sociodemographic and clinical variables affect its use in women with BD.

796 women (18-50 years old) with BD were recruited and evaluated by the MONTRA survey in France among hospital and consultant psychiatrists. Sociodemographic, clinical and treatment variables were compared between patients with and without contraception use. A logistic regression estimated which variables had a predictive effect on the use of contraception.

A 61.2% reported the use of effective contraception. Women who use contraception were in 26-35 (OR = 2.40,p < 0.001) and 36-45 (OR = 1.92,p < 0.001) range age, displayed higher levels of education (OR = 5.07,p = 0.003), were more active (OR = 1.63,p = 0.006), did not live alone (OR = 1.41,p = 0.033) and had fewer manic or mixed episodes (OR = 0.50,p = 0.007).No association was found with the nature of pharmacological treatment.

Sociodemographic variables were mainly associated with contraception use among BD women. As preventive measures for risk of relapse in BD, contraceptive counseling, including reduction of unplanned pregnancies, should be systematically ensured.