Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study
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Date
2022
Authors
Harris, M.L.
Egan, N.
Forder, P.M.
Bateson, D.
Sverdlov, A.L.
Murphy, V.E.
Loxton, D.
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Reproductive Health, 2022; 19(1):1-14
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Melissa L. Harris, Nicholas Egan, Peta M. Forder, Deborah Bateson, Aaron L. Sverdlov, Vanessa E. Murphy, and Deborah Loxton
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Abstract
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 beneft from efective 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 infuence 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-efect models were used to evaluate the relationship between contraceptive combinations and chronic disease. Results: Contraceptive use for women with cardiac and autoinfammatory diseases difered 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 autoinfammatory 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 diferences in contraceptive patterns over the observation period were found for women with asthma or diabetes when compared to women without chronic disease. Conclusion: The fndings identifed a need for efective 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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© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.