Obesity and contraceptive use among women 20–44 years of age in the United States: results from the 2011–15 National Survey of Family Growth (NSFG)

Mosher, William D.; Lantos, Hannah; Burke, Anne E.

doi:10.1016/j.contraception.2017.11.007

Cited by 13 publications

(9 citation statements)

References 19 publications

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“…The differences in the pattern of contraceptive use between these different populations with obesity might also be explained by other differences between the populations regarding parity (0 vs. 2), and age (29 vs. 36 years). This is in accordance with the results from previous studies where use of intrauterine contraception has been shown to be more common among parous women compared to nulliparous women with obesity class II-III (133).…”

Section: Contraceptive Prescription Use Reported Side Effects and Dsupporting

confidence: 93%

Contraception in women with obesity with special reference to gastric bypass surgery

Ginstman

2019

Linköping University Medical Dissertations

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Contraception in women with obesity with special reference to gastric bypass surgery  Charlotte Ginstman Cover: published by permission of Shutterstock (www.shutterstock.com) Abstract Background: The prevalence of obesity is increasing worldwide. The treatment of morbid obesity is dominated by bariatric surgery, for example Roux-en-Y gastric bypass (RYGB) surgery. If other contraceptive options are available, women with obesity should not be prescribed combined hormonal contraceptives due to the obesity-related increased risk of venous thromboembolism. Women are advised not to become pregnant during the first 12-18 months after RYGB surgery. There is a lack of knowledge of what type of contraceptive methods women with obesity are prescribed and whether they experience more or different side effects compared to normal-weight women. It is not known if the absorption and pharmacokinetic profile of progestins are affected by RYGB. The aim of this thesis was to investigate the pattern of contraceptive use in women with obesity, what type of contraceptive counselling was given to women in relation to RYGB, and whether the pharmacokinetics of two different progestins were affected by RYGB surgery. Material and Methods:Paper I is a retrospective cohort study analysing the patterns of contraceptive prescription, adverse effects, duration of treatment, reasons for discontinuation and bleeding pattern in 371 women with obesity compared with 744 normal-weight women. Medical records were scrutinised from 1 Jan 2010 until 31 Dec 2014. Paper II is based on a questionnaire sent to 987 women who had undergone RYGB during 2010. The questionnaire concerned preoperative and present contraceptive use, contraceptive counselling in relation to surgery and what type of recommendations they had received regarding pregnancy after RYGB. Papers III and IV are experimental studies investigating the pharmacokinetics of desogestrel (etonogestrel) and levonorgestrel in relation to RYGB. Results and conclusions:The most commonly prescribed contraceptive method for women with obesity was the progestin-only pill but many women with obesity were prescribed combined hormonal contraceptives despite the current recommendations of cautious prescription of oestrogen-containing methods. There were no differences in adherence to contraceptive method between women with obesity and normal-weight women. Despite the uncertainties regarding absorption, almost 10 % of women continued using oral contraceptives after RYGB. Nearly 40% were not aware of the recommendation to avoid pregnancy in the first year after RYGB and almost one third did not use any contraception during this period. This could be due to a lack of information or that the women did not retain the given information to avoid pregnancy. We found no clinically significant differences in the steady state pharmacokinetics of desogestrel before compared with after RYGB, or in single dose pharmacokinetics of levonorgestrel in women with BMI< 30 having undergone RYGB compared with BMI-matched non-op...

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Section: Contraceptive Prescription Use Reported Side Effects and Dsupporting

confidence: 93%

Contraception in women with obesity with special reference to gastric bypass surgery

Ginstman

2019

Linköping University Medical Dissertations

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“…In this respect, sexually active Hispanic, non-Hispanic black women, and women with lower education or lower income report lower use of contraceptives 77 . Differences in fertility associated with overweight/obesity may be due to behavioral factors as obese women utilize sterilization as a method of contraception more often 78 , have decreased marriage rates 79 , and a significantly higher risk of lifetime childlessness than overweight women 80 . Smoking is associated with risky sexual/health behaviors 81 , sexually transmitted diseases 82–85 , number of sexual partners 85,86 , and failure to use contraception 86 .…”

Section: Discussionmentioning

confidence: 99%

Asthma and/or hay fever as predictors of fertility/impaired fecundity in U.S. women: National Survey of Family Growth

Turkeltaub¹,

Lockey

Holmes

et al. 2019

Sci Rep

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This study addresses whether asthma and/or hay fever predict fertility and impaired fecundity. The lifetime number of pregnancies (fertility) and spontaneous pregnancy losses (impaired fecundity) in 10,847 women representative of the U.S. population 15 to 44 years of age with histories of diagnosed asthma and/or hay fever are analyzed in the 1995 National Survey of Family Growth using multivariable Poisson regression with multiple covariates and adjustments for complex sampling. Smokers have significantly increased fertility compared to nonsmokers. Smokers with asthma only have significantly increased fertility compared to other smokers. Higher fertility is associated with impaired fecundity (ectopic pregnancy, miscarriage, stillbirth). Women with asthma (with and without hay fever) have significantly higher pregnancy losses than women without asthma. With increasing number of pregnancies, smokers have increased pregnancy losses compared to nonsmokers. Smokers, especially those with asthma only, have increased fertility and require special attention as to their family planning needs, reproductive health, and smoking cessation. Women with asthma, regardless of number of pregnancies, and smokers with higher numbers of pregnancies have high risk pregnancies that require optimal asthma/medical management prenatally and throughout pregnancy. Whether a proinflammatory asthma endotype underlies both the increased fertility and impaired fecundity associated with age and smoking is discussed.

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“…However, the cause of this disparity is unclear and likely multifactorial including differences at the patientlevel, clinician-level such as implicit bias, and societal level including structural racism and barriers to care [1]. At the patient-level, variation in patient preferences including individual intention to conceive or seek pregnancy may contribute to differences in contraceptive method chosen [9,10]. Demographic and clinical factors that are correlates of contraceptive use such as age, parity, and insurance status also vary by race/ethnicity [11].…”

Section: Introductionmentioning

confidence: 99%

Association of race and ethnicity with postpartum contraceptive method choice, receipt, and subsequent pregnancy

et al. 2021

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Background We sought to assess racial/ethnic differences in choice of postpartum contraceptive method after accounting for clinical and demographic correlates of contraceptive use. Methods This is a secondary analysis of a single-center retrospective cohort study examining postpartum women from 2012 to 2014. We determined the association between self-identified race/ethnicity and desired postpartum contraception, receipt, time to receipt, postpartum visit attendance, and subsequent pregnancy within 365 days of delivery. Results Of the 8649 deliveries in this study, 46% were by Black women, 36% White women, 12% Hispanic, and 6% by women of other races. Compared with White women, Black and Hispanic women were more likely to have a postpartum contraception plan for all methods. After multivariable analysis, Hispanic women (relative to White women) were less likely to receive their chosen method (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.64–0.87). Women of races other than Black or Hispanic were less likely to experience a delay in receipt of their desired highly-effective method compared to White women (hazard ratio [HR] = 0.70, 95% CI 0.52–0.94). There were no differences between racial/ethnic groups in terms of postpartum visit adherence. Black women were more likely to be diagnosed with a subsequent pregnancy compared to White women (OR 1.17, 95% CI 1.04–1.32). Conclusion Racial/ethnic variation in postpartum contraceptive outcomes persists after accounting for clinical and demographic differences. While intrinsic patient-level differences in contraceptive preferences should be better understood and respected, clinicians should take steps to ensure that the observed differences in postpartum contraceptive plan methods between racial/ethnic groups are not due to biased counseling.

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Obesity and contraceptive use among women 20–44 years of age in the United States: results from the 2011–15 National Survey of Family Growth (NSFG)

Cited by 13 publications

References 19 publications

Contraception in women with obesity with special reference to gastric bypass surgery

Contraception in women with obesity with special reference to gastric bypass surgery

Asthma and/or hay fever as predictors of fertility/impaired fecundity in U.S. women: National Survey of Family Growth

Association of race and ethnicity with postpartum contraceptive method choice, receipt, and subsequent pregnancy

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