Elizabeth E Krans, Beatrice A Chen, Scott D Rothenberger, Debra L Bogen, Kelley Jones, Mary J Turocy, Leah C Klocke, Eleanor B Schwarz
{"title":"增加获得产后立即避孕植入物:阿片类药物使用障碍患者的前瞻性临床试验","authors":"Elizabeth E Krans, Beatrice A Chen, Scott D Rothenberger, Debra L Bogen, Kelley Jones, Mary J Turocy, Leah C Klocke, Eleanor B Schwarz","doi":"10.1080/13625187.2022.2114791","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of increased access to immediate postpartum contraceptive implants (IPI) on repeat pregnancy and contraceptive use rates among patients with opioid use disorder (OUD).</p><p><strong>Materials and methods: </strong>Between 2016 and 2018, 194 postpartum patients with OUD were offered the option of IPI placement at an institution with limited immediate postpartum long-acting reversible contraception availability and followed for one-year postpartum. Differences in pregnancy rates between participants who did and did not choose IPI were examined using logistic regression with inverse probability of treatment weighting from propensity scores accounting for differences between the two groups.</p><p><strong>Results: </strong>Among 194 participants, 96 (49.5%) chose an IPI and 98 (50.5%) chose an alternative method or no contraception (non-IPI). Among IPI participants, 76 (80.9%) continued to use their implant at one-year postpartum. Overall, 19 participants had a repeat pregnancy and 11 (57.9%) were unintended. In multivariable analyses, repeat pregnancy was more likely among those who did not choose IPI (OR 9.90; 95% CI 3.58-27.03) than those who did. Participants with OUD and who used alcohol (11.66; 1.38, 98.20) or cocaine (2.72; 1.23, 5.99) during pregnancy were more likely to choose IPI. Participants who were married (0.28; 0.09, 0.89), engaged in OUD treatment prior to pregnancy (0.48; 0.25, 0.93), and happier when they found out about their pregnancy (0.87; 0.77, 0.98) were less likely to choose IPI.</p><p><strong>Conclusion: </strong>Offering patients with OUD the option of IPI is associated with high utilisation and continuation rates, and low rates of repeat pregnancy within one-year postpartum.</p>","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9795857/pdf/","citationCount":"0","resultStr":"{\"title\":\"Increasing access to immediate postpartum contraceptive implants: a prospective clinical trial among patients with opioid use disorder.\",\"authors\":\"Elizabeth E Krans, Beatrice A Chen, Scott D Rothenberger, Debra L Bogen, Kelley Jones, Mary J Turocy, Leah C Klocke, Eleanor B Schwarz\",\"doi\":\"10.1080/13625187.2022.2114791\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the effects of increased access to immediate postpartum contraceptive implants (IPI) on repeat pregnancy and contraceptive use rates among patients with opioid use disorder (OUD).</p><p><strong>Materials and methods: </strong>Between 2016 and 2018, 194 postpartum patients with OUD were offered the option of IPI placement at an institution with limited immediate postpartum long-acting reversible contraception availability and followed for one-year postpartum. Differences in pregnancy rates between participants who did and did not choose IPI were examined using logistic regression with inverse probability of treatment weighting from propensity scores accounting for differences between the two groups.</p><p><strong>Results: </strong>Among 194 participants, 96 (49.5%) chose an IPI and 98 (50.5%) chose an alternative method or no contraception (non-IPI). Among IPI participants, 76 (80.9%) continued to use their implant at one-year postpartum. Overall, 19 participants had a repeat pregnancy and 11 (57.9%) were unintended. In multivariable analyses, repeat pregnancy was more likely among those who did not choose IPI (OR 9.90; 95% CI 3.58-27.03) than those who did. Participants with OUD and who used alcohol (11.66; 1.38, 98.20) or cocaine (2.72; 1.23, 5.99) during pregnancy were more likely to choose IPI. Participants who were married (0.28; 0.09, 0.89), engaged in OUD treatment prior to pregnancy (0.48; 0.25, 0.93), and happier when they found out about their pregnancy (0.87; 0.77, 0.98) were less likely to choose IPI.</p><p><strong>Conclusion: </strong>Offering patients with OUD the option of IPI is associated with high utilisation and continuation rates, and low rates of repeat pregnancy within one-year postpartum.</p>\",\"PeriodicalId\":50491,\"journal\":{\"name\":\"European Journal of Contraception and Reproductive Health Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2022-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9795857/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Contraception and Reproductive Health Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/13625187.2022.2114791\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/9/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Contraception and Reproductive Health Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13625187.2022.2114791","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/9/5 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨增加产后即刻避孕植入物(IPI)对阿片类药物使用障碍(OUD)患者重复妊娠和避孕药具使用率的影响。材料和方法:2016年至2018年,194名产后OUD患者在产后即时长效可逆避孕有限的机构接受IPI安置,并随访1年。选择和未选择IPI的参与者之间的妊娠率差异使用逻辑回归进行检查,从倾向评分中计算治疗加权的逆概率,说明两组之间的差异。结果:194名参与者中,96名(49.5%)选择了IPI, 98名(50.5%)选择了替代方法或不避孕(非IPI)。在IPI参与者中,76人(80.9%)在产后一年继续使用种植体。总的来说,19名参与者有重复怀孕,11名(57.9%)是意外怀孕。在多变量分析中,未选择IPI的患者更有可能重复妊娠(OR 9.90;95% CI 3.58-27.03)。患有OUD并使用酒精的参与者(11.66;1.38, 98.20)或可卡因(2.72;1.23, 5.99)孕妇更倾向于选择IPI。已婚参与者(0.28;0.09, 0.89),妊娠前接受OUD治疗(0.48;0.25, 0.93),当他们发现自己怀孕时更快乐(0.87;0.77, 0.98)不太可能选择IPI。结论:为OUD患者提供IPI的选择与高使用率和延续率相关,产后一年内重复妊娠率低。
Increasing access to immediate postpartum contraceptive implants: a prospective clinical trial among patients with opioid use disorder.
Objective: To evaluate the effects of increased access to immediate postpartum contraceptive implants (IPI) on repeat pregnancy and contraceptive use rates among patients with opioid use disorder (OUD).
Materials and methods: Between 2016 and 2018, 194 postpartum patients with OUD were offered the option of IPI placement at an institution with limited immediate postpartum long-acting reversible contraception availability and followed for one-year postpartum. Differences in pregnancy rates between participants who did and did not choose IPI were examined using logistic regression with inverse probability of treatment weighting from propensity scores accounting for differences between the two groups.
Results: Among 194 participants, 96 (49.5%) chose an IPI and 98 (50.5%) chose an alternative method or no contraception (non-IPI). Among IPI participants, 76 (80.9%) continued to use their implant at one-year postpartum. Overall, 19 participants had a repeat pregnancy and 11 (57.9%) were unintended. In multivariable analyses, repeat pregnancy was more likely among those who did not choose IPI (OR 9.90; 95% CI 3.58-27.03) than those who did. Participants with OUD and who used alcohol (11.66; 1.38, 98.20) or cocaine (2.72; 1.23, 5.99) during pregnancy were more likely to choose IPI. Participants who were married (0.28; 0.09, 0.89), engaged in OUD treatment prior to pregnancy (0.48; 0.25, 0.93), and happier when they found out about their pregnancy (0.87; 0.77, 0.98) were less likely to choose IPI.
Conclusion: Offering patients with OUD the option of IPI is associated with high utilisation and continuation rates, and low rates of repeat pregnancy within one-year postpartum.
期刊介绍:
The Official Journal of the European Society of Contraception and Reproductive Health, The European Journal of Contraception and Reproductive Health Care publishes original peer-reviewed research papers as well as review papers and other appropriate educational material.