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即時入院後長期作用型可逆的避孕措施（LARC）的可及性是否與快速重複懷孕的減少有關？

Allison Hoynes1, Brittany Cox2, Roma Amin2

  • 1From the Grant Family Medicine, OhioHealth, Columbus, OH (AH, RA, JY); Sky Lakes Medical Center, Klamath Falls, OR (BC); Wright State University Boonshoft School of Medicine, Dayton, OH (CMF); Heritage College of Osteopathic Medicine at Ohio University, Dublin, Ohio, USA (AC). allison.hoynes@ohiohealth.com.

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まとめ

產後即時長效可逆避孕（IPP-LARC）可能會降低快速重複懷孕（RRP）。雖然IPP-LARC的可及性與RRP略有正相關，但選擇IPP-LARC的患者的RRP顯著減少。

キーワード:
避孕藥諮詢地索芳藥物植入物電子健康記錄依託諾孕酮健康差異健康教育健康政策長效可逆避孕孕產婦保健服務醫療補助產科學俄亥俄州圍產期護理人口健康產後孕前護理懷孕早產預防醫學公共衛生生殖健康婦女健康

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科学分野:

  • 生殖健康
  • 公共衛生政策
  • 母胎醫學

背景:

  • 快速重複懷孕（RRP）與不良圍產期結局有關，包括早產和低出生體重。
  • 俄亥俄州立法（SB 332）要求從2017年4月開始涵蓋產後即時長效可逆避孕（IPP-LARC）。
  • 我院在立法後引入了Nexplanon作為IPP-LARC選項。

研究 の 目的:

  • 評估IPP-LARC的可及性與SB 332通過後RRP發生率之間的關聯。
  • 確定與我們機構的青少年和成人RRP相關的因素。

主な方法:

  • 回顧性研究分析了IPP-LARC可用前後的726名患者的數據。
  • 利用電子健康記錄和州登記數據檢查了社會人口統計學和圍產期護理變量。
  • 確定了RRP與這些變量之間的關聯。

主要な成果:

  • 僅有62名患者選擇了Nexplanon（IPP-LARC），總計368名患者。
  • 與未使用IPP-LARC的患者相比，使用IPP-LARC的患者的RRP調整後平均概率為6%，而未使用者為20%。
  • 妊娠次數和陰道分娩與RRP呈負相關，而分娩年齡與RRP呈反向相關。

結論:

  • IPP-LARC的可及性與RRP呈正相關，但無統計學意義。
  • 儘管使用率很低，但使用IPP-LARC的患者的RRP發生率較低。
  • 加強患者教育和提供者支持對於優化弱勢群體對IPP-LARC的使用至關重要。