Uptake of postplacental intrauterine device placement at cesarean delivery

Sweeney, Heather E.; Bainvoll, Liat; Mandelbaum, Rachel S.; Sangara, Rauvynne N.; Violette, Caroline; Klar, Maximilian; Matsushima, Kazuhide; Paulson, Richard J.; Cahoon, Sigita S.; Nguyen, Brian; Bender, Nicole; Ouzounian, Joseph G.; Matsuo, Koji

doi:10.1016/j.xagr.2022.100157

Cited by 1 publication

(1 citation statement)

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“…26 Thirdly, the exposure-outcome association was assessed according to race (white or non-white), as prior studies suggested that patient's choice for LARC and surgical sterilization may differ based on this. 14,27,31 Lastly, cases with an unknown status for study covariates were excluded from the analysis.…”

Section: Analytic Approachmentioning

confidence: 99%

Contraception and sterilization selection at delivery among pregnant patients with malignancy

Harris

Mandelbaum

Rau

et al. 2023

Acta Obstet Gynecol Scand

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IntroductionSince malignancy during pregnancy is uncommon, information regarding contraception selection or sterilization at delivery is limited. The objective of this study was to examine the type of long‐acting reversible contraception or surgical sterilization procedure chosen by pregnant patients with malignancy at delivery.Material and methodsThis cross‐sectional study queried the Healthcare Cost and Utilization Project's National Inpatient Sample in the USA. The study population was vaginal and cesarean deliveries in a hospital setting from January 2017 to December 2020. Pregnant patients with breast cancer (n = 1605), leukemia (n = 1190), lymphoma (n = 1120), thyroid cancer (n = 715), cervical cancer (n = 425) and melanoma (n = 400) were compared with 14 265 319 pregnant patients without malignancy. The main outcome measures were utilization of long‐acting reversible contraception (subdermal implant or intrauterine device) and performance of permanent surgical sterilization (bilateral tubal ligation or bilateral salpingectomy) during the index hospital admission for delivery, assessed with a multinomial regression model controlling for clinical, pregnancy and delivery characteristics.ResultsWhen compared with pregnant patients without malignancy, pregnant patients with breast cancer were more likely to proceed with bilateral salpingectomy (adjusted odds ratio [aOR] 2.30) or intrauterine device (aOR 1.91); none received the subdermal implant. Pregnant patients with leukemia were more likely to choose a subdermal implant (aOR 2.22), whereas those with lymphoma were more likely to proceed with bilateral salpingectomy (aOR 1.93) and bilateral tubal ligation (aOR 1.76). Pregnant patients with thyroid cancer were more likely to proceed with bilateral tubal ligation (aOR 2.21) and none received the subdermal implant. No patients in the cervical cancer group selected long‐acting reversible contraception, and they were more likely to proceed with bilateral salpingectomy (aOR 2.08). None in the melanoma group chose long‐acting reversible contraception. Among pregnant patients aged <30, the odds of proceeding with bilateral salpingectomy were increased in patients with breast cancer (aOR 3.01), cervical cancer (aOR 2.26) or lymphoma (aOR 2.08). The odds of proceeding with bilateral tubal ligation in pregnant patients aged <30 with melanoma (aOR 5.36) was also increased.ConclusionsThe results of this nationwide assessment in the United States suggest that among pregnant patients with malignancy, the preferred contraceptive option or method of sterilization at time of hospital delivery differs by malignancy type.

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Section: Analytic Approachmentioning

confidence: 99%