为有药物使用障碍的妇女制定产后避孕计划:利用分娩许可。

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Australian & New Zealand Journal of Obstetrics & Gynaecology Pub Date : 2024-10-21 DOI:10.1111/ajo.13887
Kelly A McNamara, Kirsten Black, Oliver Bond, Bridin Murnion, Adrienne Gordon, Joanne Ludlow, Natasha Nassar
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引用次数: 0

摘要

背景:与没有药物使用障碍的妇女相比,患有药物使用障碍(SUD)的妇女避孕率较低,意外怀孕率较高。产后六周的预约会讨论避孕问题,但许多有药物滥用障碍的妇女并不参加预约。因此,重要的是让妇女有机会在出院前制定避孕计划。目的:评估有严重精神障碍妇女的产后避孕计划,包括开始避孕的时间和感兴趣的避孕方法,并将其与无严重精神障碍妇女进行比较:对新南威尔士州一个地方卫生区 2011 年 1 月至 2019 年 9 月的所有新生儿进行了分析。数据包括产妇人口统计学、SUD 和避孕计划。采用卡方统计和多变量多项式回归分析来比较有 SUD 和无 SUD 妇女的结果:在 59 195 名母亲中,有 429 名(0.7%)患有 SUD。50.1%的有 SUD 妇女和 56.2%的无 SUD 妇女(P = 0.03)没有记录避孕计划。有 37.3% 的有 SUD 妇女和 42.4% 的无 SUD 妇女(P = 0.06)有避孕处方或避孕转介。有 12.5%患有 SUD 的妇女和 1.4%未患有 SUD 的妇女(P=0.06):尽管有严重精神障碍的妇女产后开始避孕的比例较高,但有一半的妇女(无论是否有严重精神障碍)在出院时没有计划开始避孕。将提供产后避孕纳入产科护理,或调查其他机会,可能会改善所有妇女(包括患有 SUD 的妇女)获得避孕的机会。
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Planning postpartum contraception for women with substance use disorders: Utilisation of the birth admission.

Background: Women with substance use disorders (SUD) use less contraception, and experience higher rates of unintended pregnancy, compared to women without SUD. Contraception is discussed at the six-week postnatal appointment, which many women with SUD do not attend. Therefore, it is important women have the opportunity to formulate contraception plans before discharge from the birth admission.

Aims: To assess postpartum contraception plans, including initiation and method of interest, among women with SUD and compare these to women without SUD.

Materials and methods: All births from January 2011 to September 2019 from one New South Wales local health district were analysed. Data included maternal demographics, SUD, and contraception plans. Chi-squared statistics and multivariate multinomial regression analyses were used to compare outcomes for women with and without SUD.

Results: Of 59 195 mothers, 429 (0.7%) had a SUD. There were 50.1% of women with SUD and 56.2% without SUD (P = 0.03) who had no documented plan for contraception. There were 37.3% of women with SUD and 42.4% without SUD (P = 0.06) who had a prescription for contraception or a referral to discuss contraception. There were 12.5% of women with SUD and 1.4% without SUD (P < 0.001) who initiated contraception in hospital.

Conclusions: Although postpartum contraception initiation was higher among women with SUD, half of all women (with or without SUD) were discharged without a plan for contraception initiation. Embedding provision of postpartum contraception into maternity care, or investigating other opportunities, may improve access for all women, including those with SUD.

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来源期刊
CiteScore
3.40
自引率
11.80%
发文量
165
审稿时长
4-8 weeks
期刊介绍: The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.
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