Preconception care and contraceptive use among Australian women with diabetes mellitus

Hibbert, Emily; Chalasani, Santhi; Kozan, Pinar; Myszka, Rickie; Park, Kris Ej; Black, Kirsten

doi:10.31128/ajgp-03-18-4529

Cited by 12 publications

(15 citation statements)

References 15 publications

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“…In our study no discernible difference in the contraceptive patterns between women with diabetes compared to women without chronic disease using the pill were found. While the international evidence around this topic has been equivocal, Australian research has found that although women with diabetes are high users of contraception (mostly condoms and the oral contraceptive pill), contraception is not consistently used [ 30 ]. This is important given that the pill and condoms are the most prevalent forms of contraception used at the time of unintended pregnancy among young Australian women [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study

et al. 2022

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Background Given chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor maternal and fetal outcomes, these women would benefit from effective preconception care. However, there is a lack of understanding of how these women use or don’t use contraception to inform such interventions. This study examined patterns of contraceptive use among an Australian cohort of young women and investigated the influence of chronic disease on contraceptive use over time. Methods Using data from 15,244 young women from the Australian Longitudinal Study on Women’s Health (born 1989–1995), latent transition analysis was performed to identify distinct contraceptive patterns among women who were at risk of an unintended pregnancy. Multinomial mixed-effect models were used to evaluate the relationship between contraceptive combinations and chronic disease. Results Contraceptive use for women with cardiac and autoinflammatory diseases differed to women without chronic disease over the observation period. Compared to women without chronic disease using the pill, women with cardiac disease had double the odds of using ‘other’ contraception and condoms (OR = 2.20, 95% CI 1.34, 3.59) and a modest increase in the odds of using the combined oral contraceptive pill and condoms (OR = 1.39, 95% CI 1.03, 1.89). Compared to women without chronic disease who used the pill, women with autoinflammatory disease had increased odds of using LARC and condoms (OR = 1.58, 95% CI 1.04, 2.41), using ‘other’ contraception and condoms (OR = 1.69, 95% CI 1.11, 2.57), and using the combined oral contraceptive pill and condoms (OR = 1.38, 95% CI 1.09, 1.75). No differences in contraceptive patterns over the observation period were found for women with asthma or diabetes when compared to women without chronic disease. Conclusion The findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between health care providers and women with chronic disease to improve young women’s contraceptive knowledge and agency in contraceptive choice, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study

et al. 2022

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show abstract

“…In our study no discernible difference in the contraceptive patterns between women with diabetes compared to women without chronic disease using the pill were found. While the international evidence around this topic has been equivocal, Australian research has found that although women with diabetes are high users of contraception (mostly condoms and the oral contraceptive pill), contraception is not consistently used [29]. This is important given that the pill and condoms are the most prevalent forms of contraception used at the time of unintended pregnancy among young Australian women [30].…”

Section: Discussionmentioning

confidence: 99%

Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study

Egan¹,

Forder²,

Bateson

et al. 2021

Preprint

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Background Given chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor maternal and fetal outcomes, these women would benefit from effective preconception care. However, there is a lack of understanding of how these women use or don’t use contraception to inform such interventions. This study examined patterns of contraceptive use among an Australian cohort of young women, with and without chronic disease, and investigated factors which influenced contraceptive use over time. Methods Using data from 15,244 young women from the Australian Longitudinal Study on Women’s Health (born 1989-95), latent transition analysis was performed to identify distinct contraceptive patterns among women who were at risk of an unintended pregnancy. Multinomial mixed-effect models were used to evaluate the relationship between contraceptive combinations and chronic disease. Results Differences in contraceptive use over time were found for women with cardiac disease, those with autoinflammatory diseases. Compared to women without chronic disease using the pill alone, women with cardiac disease had double the odds of using ‘other’ low efficacy contraception and condoms (OR=2.2, 95% CI: 1.34-3.59) and a modest increase in the odds of using the combined oral contraceptive pill and condoms (OR=1.39, 95% CI: 1.03-1.89). Women with autoinflammatory disease had increased odds of using LARC and condoms (OR=1.58, 95% CI: 1.04-2.41), using ‘other’ low efficacy contraception and condoms (OR=1.69, 95% CI: 1.11-2.57), and using combined oral contraceptive pill and condom use (OR=1.38, 95% CI: 1.09-1.75), compared to women without chronic disease using the pill. There was little evidence to suggest that contraceptive patterns differed for women with asthma or diabetes from women without chronic disease. Conclusion The findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between healthcare providers and women with chronic disease to improve young women’s contraceptive knowledge and agency in contraceptive choice, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.

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“…Based on an extensive literature review, we developed a self-administered questionnaire in the Thai language [13,[17][18][19][20] . This questionnaire was approved by an endocrinologist (WN) and two family planning experts (SS and UJ).…”

Section: Measurement Toolsmentioning

confidence: 99%

“…The demographics, reproductive history, diabetic status and other comorbidities, knowledge, attitudes, and practices regarding preconception care were covered in this ve-part questionnaire. Age, address, religion, reimbursement, marital status, highest educational attainment, occupation, income, number of living children, and contraceptive history were all included in the demographic and reproductive history information [17]. Age at DM diagnosis, disease activity, DM-related complications, current DM medication, and other comorbidities were all considered when determining DM status and other comorbidities [17].…”

Section: Measurement Toolsmentioning

confidence: 99%

Reproductive care in Thai women with diabetes mellitus: A descriptive cross-sectional study

Pothongsangarun,

Li,

Naeowong

et al. 2023

Preprint

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Background Pre-existing diabetes mellitus (DM) is a challenging pregnancy complication as poor glycemic control is associated with adverse maternal and fetal outcomes. In this study, we aimed to investigate DM-related knowledge, attitudes, preconception care practices, and contraceptive prevalence in women with DM. Methods This descriptive cross-sectional survey was conducted among reproductive-aged Thai women receiving DM treatment at King Chulalongkorn Memorial Hospital between August 1, 2021, and June 30, 2022. Patients with DM who were not pregnant or trying to conceive and could be contacted via the phone were included and a validated self-administered questionnaire was distributed electronically. Results A total of 238 participants were included in the final analysis, yielding 69.4% response rates. The median (interquartile range [IQR]) score for knowledge of pregnancy planning and pregnancy-related risks was 6.0 (3.4) out of 15. Only about half of the participants had discussed pregnancy planning with their physicians. Multivariable analysis showed that younger age at DM diagnosis, married, higher education, and medical personnel were significantly associated with higher knowledge scores. Women aged > 45 and those with higher practice scores had significantly higher adjusted odds of using highly effective contraception; the most common methods included male condoms and combined oral contraceptive pills. There was an unmet need for contraception in 9.5% of women with DM. Conclusions Although highly effective contraception is safe for patients with DM, only about half of our participants used tier one or two contraceptives or had received consultation regarding preconception planning. There was a notable gap in care coordination among specialists; integrating reproductive healthcare into DM therapy would improve access to preconception care.

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Preconception care and contraceptive use among Australian women with diabetes mellitus

Abstract: Background and objective Effective contraception is important for pregnancy planning and reducing adverse pregnancy outcomes in women with diabetes mellitus (DM). The aim of this study was to explore preconception care practices and contraception use among women with DM.

Cited by 12 publications

References 15 publications

Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study

Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study

Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study

Reproductive care in Thai women with diabetes mellitus: A descriptive cross-sectional study

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