Women with sickle cell disease report low knowledge and use of long acting reversible contraception

Pecker, Lydia H.; Hussain, Sarah; Lanzkron, Sophie; Tao, Xuguang Grant; Thaler, Katrina; Burke, Anne E.; Whaley, Natalie

doi:10.1016/j.jnma.2021.05.005

Cited by 15 publications

(22 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 Despite worse pregnancy outcomes, the proportion of unplanned pregnancies among women with SCD appears to be no different than that of the general population, with almost half reporting having experienced unplanned pregnancy(ies). 13,14 In the U.S. and other high-resource countries, contraception use reported by women with SCD to prevent unplanned pregnancies varies. [14][15][16][17][18][19][20] Low reliability of contraception use and unintended pregnancy are reportedly common in women with SCD.…”

Section: Introductionmentioning

confidence: 99%

“…13,14 In the U.S. and other high-resource countries, contraception use reported by women with SCD to prevent unplanned pregnancies varies. [14][15][16][17][18][19][20] Low reliability of contraception use and unintended pregnancy are reportedly common in women with SCD. 14 A recent study found that the proportion of women with SCD who used contraception was significantly lower than that of women in the general population.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16][17][18][19][20] Low reliability of contraception use and unintended pregnancy are reportedly common in women with SCD. 14 A recent study found that the proportion of women with SCD who used contraception was significantly lower than that of women in the general population. 20 The use of longacting reversible contraception was also reported as low: 5 and 15%…”

Section: Introductionmentioning

confidence: 99%

“…for contraceptive implants and intrauterine devices, respectively. 14,20 Additional pregnancy-related safety concerns exist due to potential teratogenic effects of medications used to treat SCD, especially hydroxyurea. [21][22][23] Despite these concerns, female AYAs with SCD in one study reported only infrequent discussions about contraception and fertility when prescribed hydroxyurea.…”

Section: Introductionmentioning

confidence: 99%

“…A recent study found that the proportion of women with SCD who used contraception was significantly lower than that of women in the general population 20 . The use of long‐acting reversible contraception was also reported as low: 5 and 15% for contraceptive implants and intrauterine devices, respectively 14,20 . Additional pregnancy‐related safety concerns exist due to potential teratogenic effects of medications used to treat SCD, especially hydroxyurea 21–23 .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Pediatric hematology providers’ contraceptive practices for female adolescents and young adults with sickle cell disease: A national survey

Askew

Smaldone

Gold

et al. 2022

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Background: Adolescent and young adult (AYA) women with sickle cell disease (SCD) have increased pregnancy-related health risks and are prescribed potentially teratogenic medications, yet limited data are available regarding pediatric SCD provider contraceptive practices. We aimed to assess pediatric hematology providers' beliefs, practices, motivators, and barriers for providing contraceptive care to female AYAs with SCD.Methods: Guided by the Health Belief Model (HBM), we developed a 25-question, web-based survey to assess practices. Survey links were distributed nationwide to pediatric SCD and/or general hematology providers through their publicly available emails and by request to directors of U.S.-accredited Pediatric Hematology-Oncology fellowship programs for distribution to their SCD providers. Data analysis included descriptive statistics, chi-square analysis, and logistic regression.Results: Of 177 respondents, 160 surveys meeting inclusion criteria were analyzed.Most providers reported counseling (77.5%) and referring female AYA patients for contraception (90.8%), but fewer reported prescribing contraception (41.8%). Proportionally fewer trainees provided counseling compared with established providers (54% vs. 85%, p < .001), with a similar trend for prescribing (p = .05). Prescription practices did not differ significantly by provider beliefs regarding potential teratogenicity of hydroxyurea.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pediatric hematology providers’ contraceptive practices for female adolescents and young adults with sickle cell disease: A national survey

Askew

Smaldone

Gold

et al. 2022

Pediatric Blood & Cancer

View full text Add to dashboard Cite

show abstract

Association of Sickle Cell Disease With Racial Disparities and Severe Maternal Morbidities in Black Individuals

et al. 2023

View full text Add to dashboard Cite

ImportanceLittle is known about the association between sickle cell disease (SCD) and severe maternal morbidity (SMM).ObjectiveTo examine the association of SCD with racial disparities in SMM and with SMM among Black individuals.Design, Setting, and ParticipantsThis cohort study was a retrospective population-based investigation of individuals with and without SCD in 5 states (California [2008-2018], Michigan [2008-2020], Missouri [2008-2014], Pennsylvania [2008-2014], and South Carolina [2008-2020]) delivering a fetal death or live birth. Data were analyzed between July and December 2022.ExposureSickle cell disease identified during the delivery admission by using International Classification of Diseases, Ninth Revision and Tenth Revision codes.Main Outcomes and MeasuresThe primary outcomes were SMM including and excluding blood transfusions during the delivery hospitalization. Modified Poisson regression was used to estimate risk ratios (RRs) adjusted for birth year, state, insurance type, education, maternal age, Adequacy of Prenatal Care Utilization Index, and obstetric comorbidity index.ResultsFrom a sample of 8 693 616 patients (mean [SD] age, 28.5 [6.1] years), 956 951 were Black individuals (11.0%), of whom 3586 (0.37%) had SCD. Black individuals with SCD vs Black individuals without SCD were more likely to have Medicaid insurance (70.2% vs 64.6%), to have a cesarean delivery (44.6% vs 34.0%), and to reside in South Carolina (25.2% vs 21.5%). Sickle cell disease accounted for 8.9% and for 14.3% of the Black-White disparity in SMM and nontransfusion SMM, respectively. Among Black individuals, SCD complicated 0.37% of the pregnancies but contributed to 4.3% of the SMM cases and to 6.9% of the nontransfusion SMM cases. Among Black individuals with SCD compared with those without, the crude RRs of SMM and nontransfusion SMM during the delivery hospitalization were 11.9 (95% CI, 11.3-12.5) and 19.8 (95% CI, 18.5-21.2), respectively, while the adjusted RRs were 3.8 (95% CI, 3.3-4.5) and 6.5 (95% CI, 5.3-8.0), respectively. The SMM indicators that incurred the highest adjusted RRs included air and thrombotic embolism (4.8; 95% CI, 2.9-7.8), puerperal cerebrovascular disorders (4.7; 95% CI, 3.0-7.4), and blood transfusion (3.7; 95% CI, 3.2-4.3).Conclusions and RelevanceIn this retrospective cohort study, SCD was found to be an important contributor to racial disparities in SMM and was associated with an elevated risk of SMM among Black individuals. Efforts from the research community, policy makers, and funding agencies are needed to advance care among individuals with SCD.

show abstract

Pregnancy outcomes in women with sickle cell disease in California

et al. 2023

View full text Add to dashboard Cite

Adverse pregnancy outcomes occur frequently in women with sickle cell disease (SCD) across the globe. In the United States, Black women experience disproportionately worse maternal health outcomes than all other racial groups. To better understand how social determinants of health impact SCD maternal morbidity, we used California's Department of Health Care Access and Information data (1991–2019) to estimate the cumulative incidence of pregnancy outcomes in Black women with and without SCD—adjusted for age, insurance status, and Distressed Community Index (DCI) scores. Black pregnant women with SCD were more likely to deliver at a younger age, use government insurance, and live in at‐risk or distressed neighborhoods, compared to those without SCD. They also experienced higher stillbirths (26.8, 95% confidence interval [CI]: 17.5–36.1 vs. 12.4 [CI: 12.1–12.7], per 1000 births) and inpatient maternal mortality (344.5 [CI: 337.6–682.2] vs. 6.1 [CI: 2.3–8.4], per 100 000 live births). Multivariate logistic regression models showed Black pregnant women with SCD had significantly higher odds ratios (OR) for sepsis (OR 14.89, CI: 10.81, 20.52), venous thromboembolism (OR 13.60, CI: 9.16, 20.20), and postpartum hemorrhage (OR 2.25, CI 1.79–2.82), with peak onset in the second trimester, third trimester, and six weeks postpartum, respectively. Despite adjusting for sociodemographic factors, Black women with SCD still experienced significantly worse pregnancy outcomes than those without SCD. We need additional studies to determine if early introduction to reproductive health education, continuation of SCD‐modifying therapies during pregnancy, and increasing access to multidisciplinary perinatal care can reduce morbidity in pregnant women with SCD.

show abstract

Women with sickle cell disease report low knowledge and use of long acting reversible contraception

Cited by 15 publications

References 30 publications

Pediatric hematology providers’ contraceptive practices for female adolescents and young adults with sickle cell disease: A national survey

Pediatric hematology providers’ contraceptive practices for female adolescents and young adults with sickle cell disease: A national survey

Association of Sickle Cell Disease With Racial Disparities and Severe Maternal Morbidities in Black Individuals

Pregnancy outcomes in women with sickle cell disease in California

Contact Info

Product

Resources

About