Manaf Rosliza Abdul, Ismail Irmi Zarina, Latiff Latiffah A
Department of Community Health, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia.
Glob J Health Sci. 2012 Aug 1;4(5):91-9. doi: 10.5539/gjhs.v4n5p91.
Women with chronic medical conditions are at higher risk of adverse pregnancy outcomes, which may be minimized through optimal preconception care and appropriate contraceptive use. This study aimed to describe contraceptive use among women with chronic medical conditions and factors associated with its non-use.
This study used cross-sectional data from a family planning survey among women with chronic medical conditions conducted in three health facilities in a southern state of Malaysia. A total of 450 married women in reproductive age (18-50 year) with intact uterus, and do not plan to conceive were analysed for contraceptive use. Both univariate and multivariate analysis was conducted to identify factors associated with contraceptive non-use among the study participants.
A total of 312 (69.3%) of the study participants did not use contraceptive. Contraceptive non-use was highest among the diabetics (71.2%), connective tissue disease patients (68.6%) and hypertensive patients (65.3%). Only 26.3% of women with heart disease did not use contraceptive. In the multivariate analysis, contraceptive non-use was significantly more common among women who received their medical treatment in the health clinics as compared to those who received treatment in the hospital (adjusted odds ratio [OR]=1.75, 95% confidence interval [CI]: 1.09, 2.79), being in older age group of 41-50 year (adjusted OR=2.31, 95% CI: 1.19, 4.48), having children (adjusted OR=4.57, 95% CI: 1.66, 12.57) and having lower education (adjusted OR=2.87, 95% CI: 1.43, 5.77).
About two-third of women with chronic medical conditions who needed contraceptive did not use them despite the higher risk of pregnancy related complications. The high unmet need warrant an effective health promotion programme to encourage the uptake of contraceptives especially targeting women of older age group, low education and those who received their medical treatment at health clinics.
患有慢性疾病的女性出现不良妊娠结局的风险更高，通过最佳孕前保健和适当使用避孕药具可将这种风险降至最低。本研究旨在描述患有慢性疾病的女性的避孕药具使用情况及其未使用的相关因素。
本研究使用了在马来西亚南部一个州的三个卫生机构对患有慢性疾病的女性进行的计划生育调查中的横断面数据。对总共450名年龄在18至50岁、子宫完好且不打算怀孕的已婚育龄妇女的避孕药具使用情况进行了分析。采用单因素和多因素分析来确定研究参与者中与未使用避孕药具相关的因素。
共有312名（69.3%）研究参与者未使用避孕药具。糖尿病患者（71.2%）、结缔组织病患者（68.6%）和高血压患者（65.3%）中未使用避孕药具的比例最高。只有26.3%的心脏病女性未使用避孕药具。在多因素分析中，与在医院接受治疗的女性相比，在诊所接受治疗的女性未使用避孕药具的情况显著更为常见（调整后的优势比[OR]=1.75，95%置信区间[CI]：1.09，2.79），年龄在41至50岁的老年组（调整后的OR=2.31，95%CI：1.19，4.48），有子女（调整后的OR=4.57，95%CI：1.66，12.57）以及教育程度较低（调整后的OR=2.87，95%CI：1.43，5.77）。
尽管患有慢性疾病的女性发生妊娠相关并发症的风险较高，但约三分之二需要避孕的此类女性未使用避孕药具。这种未满足的高需求需要一个有效的健康促进项目，以鼓励特别是针对老年组、低教育程度以及在诊所接受治疗的女性使用避孕药具。
