可逆产后避孕是否可以降低怀孕情况复发的风险? 来自缅因州的一项基于索赔的纵向研究
Katherine A Ahrens1, Kristin Palmsten2, Heather S Lipkind3
1Associate Research Professor, Muskie School of Public Service, University of Southern Maine, Portland, ME, USA.
在分娩后60天内开始产后避孕可以延长妊娠间隔的时间,但不会降低重复怀孕的风险,例如产前抑郁症,HDP或GDM.
科学领域:
- 生殖健康 生殖健康
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 公共卫生 公共卫生
背景情况:
- 重复出现的妊娠状况会给健康带来重大风险.
- 有效的产后避孕可以影响妊娠间隔 (IPI).
- 产后避孕对重复怀孕条件的影响尚未完全理解.
研究的目的:
- 为了确定可逆性产后避孕药是否会影响随后怀孕条件复发的风险.
- 调查这种效应是否由妊娠间隔 (IPI) 的变化介导.
主要方法:
- 缅因州所有付款人索赔数据 (2007-2019) 的分析.
- 包括活产后在60个月内怀孕的妇女.
- 对产前抑郁症,妊娠高血压障碍 (HDP) 和妊娠糖尿病 (GDM) 复发的检查.
- 有效的可逆产后避孕 (分娩后60天内) 和短期IPI (≤12个月) 的定义.
- 用于风险比率估计的日志-二项式回归模型,与混调整.
主要成果:
- 41%的妇女在产后60天内开始使用可逆避孕措施.
- 短期IPI患病率为26%;复发风险在38% (HDP) 到55% (产前抑郁症) 之间.
- 产后避孕措施的启动与产前抑郁症,HDP或GDM复发的减少无关 (aRR为0.97-1.00).
- 开始产后避孕与较低的短期IPI风险相关 (aRR为0.67-0.74).
结论:
- 在产后60天内启动产后可逆避孕措施可以延长IPI.
- 这种做法似乎没有降低复发性产前抑郁症,HDP或GDM的风险.
- 产后干预措施的机会被错过了,以减轻重复的妊娠状况风险.
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