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立即住院产后长效可逆避孕 (LARC) 的可用性是否与快速重复怀孕的减少有关?

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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概括

产后立即长效可逆避孕 (IPP-LARC) 可以减少快速重复怀孕 (RRP). 虽然IPP-LARC可用性与RRP有轻微的积极关联,但选择IPP-LARC的患者的RRP显著减少.

关键词:
避孕药是一种避孕药.咨询 咨询 咨询 咨询 咨询这种药物叫做desogestrel.药物植入物 药物植入物电子健康记录电子健康记录埃托诺格斯特雷尔 (Etonogestrel) 是一种药物.健康差异 在健康上的差异卫生教育卫生教育教育卫生政策 卫生政策长效可逆避孕方法 长效可逆避孕方法产妇健康服务 产妇健康服务医疗补助公司 (Medicaid) 的医疗补助.产科 产科 产科 产科 产科俄俄州 俄俄州 俄俄州 是一个围产期护理 围产期护理人口健康 人口健康产后期 产后时期在怀孕前的护理.怀孕 怀孕 怀孕 怀孕过早的出生 过早的出生预防医学 预防医学公共卫生 公共卫生生殖健康 生殖健康妇女健康 妇女健康

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科学领域:

  • 生殖健康 生殖健康
  • 公共卫生政策 公共卫生政策
  • 孕产妇和胎儿医学 孕产妇和胎儿医学

背景情况:

  • 快速重复怀孕 (RRP) 与不良的周产期结果有关,包括早产和低出生体重.
  • 俄俄州立法 (SB 332) 要求从2017年4月开始立即产后长效可逆避孕 (IPP-LARC) 覆盖.
  • 我们的医院在立法后推出了Nexplanon作为IPP-LARC选项.

研究的目的:

  • 评估IPP-LARC可用性与SB 332通过后的RRP率之间的关联.
  • 为了确定与RRP相关的因素在青少年和成年人交付在我们的机构.

主要方法:

  • 一项回顾性研究分析了IPP-LARC可用前后726名患者的数据.
  • 电子健康记录和国家注册数据被用来检查社会人口统计和围产期护理变量.
  • 确定了RRP与这些变量之间的关联.

主要成果:

  • 在368名患者中,只有62人选择了Nexplanon (IPP-LARC).
  • 调整后的RRP平均概率在IPP-LARC患者中为6%,而在没有IPP-LARC患者中为20%.
  • 怀孕和阴道分娩与RRP负相关,而分娩时的年龄与RRP相反相关.

结论:

  • IPP-LARC可用性与RRP有积极的,但不显著的关联.
  • 尽管吸收率较低,但使用IPP-LARC的患者的RRP率较低.
  • 加强患者教育和提供者支持对于优化IPP-LARC在弱势群体中的利用至关重要.