um contraception in high risk women's groups
ESC Congress Library. Gante I. 05/28/14; 50616; A-201
Dr. Inês Gante
Dr. Inês Gante
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Abstract
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Objectives: The aim of this study was to analyze the postpartum contraception in high risk women\'s groups, particularly, the option for long-acting reversible contraceptives (LARCs), such as intrauterine device (IUD) and hormonal implant.


Material and methods: A retrospective and comparative study of women\'s postpartum contraceptive options whose medical surveillance was between 2003 and 2013 at our unit (n=3649). We compare the different high risk groups (adolescents, women with substance-related disorders, social risk, psychological disorders and psychiatric diseases) with a control group (postpartum healthy women). Data analysis was done using o SPSS Statistics 21.0.


Results: In the control group (n=744) the postpartum mean age was 31,0±4,2 [20-45] years; the majority of these women chose hormonal oral contraception (88,8%), 8,9% chose LARCs and 2,2% chose a definitive contraception (with tubal sterilization).
In the adolescents\' group (n=462) the postpartum mean age was 17,5±1,3 [13-19] years; 50,6% chose hormonal oral contraception (p<0,001), 38,3% LARCs (37,7% hormonal implant vs 0,6% IUD) (p<0,001) and none of them chose definitive contraception (p<0,001).
In the group of women with substance-related disorders (n=139) the postpartum mean age was 29,7±5,1 [19-49] years; 53,2% chose hormonal oral contraception (p<0,001), 38,8% LARCs (38,1% hormonal implant vs 0,7% IUD) (p<0,001) and 7,2% definitive contraception (p<0,001).
In the social risk women\'s group (n=1371) the postpartum mean age was 27,9±6,1 [19-46] years; 62,1% chose hormonal oral contraception (p<0,001), 30,3% LARCs (28,0% hormonal implant vs 2,3% IUD) (p<0,001) and 6,3% definitive contraception (p<0,001).
In the psychological disorders women\'s group (n=415) the postpartum mean age was 28,8±5,7 [19-44] years; 76,1% chose hormonal oral contraception (p<0,001), 18,8% LARCs (15,7% hormonal implant vs 3,1% IUD) (p<0,001) and 4,6% definitive contraception (p<0,001).
In the group of women with psychiatric diseases (n=518) the postpartum mean age was 31,4±5,4 [19-46] years; 68,9% chose hormonal oral contraception (p<0,001), 23,2% LARCs (20,7% hormonal implant vs 2,5% IUD) (p<0,001) and 7,5% definitive contraception (p<0,001).


Conclusions: In the high risk women\'s groups, the option for LARCs (particularly, hormonal implant) was very frequent. LARCs are more effective than hormonal oral contraception and condoms, and require minimal effort for perfect compliance. The use of one of these methods has great potential to avoid unintended pregnancies. The care providers should have an active role in increasing awareness of LARCs in high risk groups, rather than relying on patient request for methods of which they have little knowledge.

Objectives: The aim of this study was to analyze the postpartum contraception in high risk women\'s groups, particularly, the option for long-acting reversible contraceptives (LARCs), such as intrauterine device (IUD) and hormonal implant.


Material and methods: A retrospective and comparative study of women\'s postpartum contraceptive options whose medical surveillance was between 2003 and 2013 at our unit (n=3649). We compare the different high risk groups (adolescents, women with substance-related disorders, social risk, psychological disorders and psychiatric diseases) with a control group (postpartum healthy women). Data analysis was done using o SPSS Statistics 21.0.


Results: In the control group (n=744) the postpartum mean age was 31,0±4,2 [20-45] years; the majority of these women chose hormonal oral contraception (88,8%), 8,9% chose LARCs and 2,2% chose a definitive contraception (with tubal sterilization).
In the adolescents\' group (n=462) the postpartum mean age was 17,5±1,3 [13-19] years; 50,6% chose hormonal oral contraception (p<0,001), 38,3% LARCs (37,7% hormonal implant vs 0,6% IUD) (p<0,001) and none of them chose definitive contraception (p<0,001).
In the group of women with substance-related disorders (n=139) the postpartum mean age was 29,7±5,1 [19-49] years; 53,2% chose hormonal oral contraception (p<0,001), 38,8% LARCs (38,1% hormonal implant vs 0,7% IUD) (p<0,001) and 7,2% definitive contraception (p<0,001).
In the social risk women\'s group (n=1371) the postpartum mean age was 27,9±6,1 [19-46] years; 62,1% chose hormonal oral contraception (p<0,001), 30,3% LARCs (28,0% hormonal implant vs 2,3% IUD) (p<0,001) and 6,3% definitive contraception (p<0,001).
In the psychological disorders women\'s group (n=415) the postpartum mean age was 28,8±5,7 [19-44] years; 76,1% chose hormonal oral contraception (p<0,001), 18,8% LARCs (15,7% hormonal implant vs 3,1% IUD) (p<0,001) and 4,6% definitive contraception (p<0,001).
In the group of women with psychiatric diseases (n=518) the postpartum mean age was 31,4±5,4 [19-46] years; 68,9% chose hormonal oral contraception (p<0,001), 23,2% LARCs (20,7% hormonal implant vs 2,5% IUD) (p<0,001) and 7,5% definitive contraception (p<0,001).


Conclusions: In the high risk women\'s groups, the option for LARCs (particularly, hormonal implant) was very frequent. LARCs are more effective than hormonal oral contraception and condoms, and require minimal effort for perfect compliance. The use of one of these methods has great potential to avoid unintended pregnancies. The care providers should have an active role in increasing awareness of LARCs in high risk groups, rather than relying on patient request for methods of which they have little knowledge.

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