Szpotanska-Sikorska Monika, Pietrzak Bronislawa, Wielgos Miroslaw
1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
Contraception. 2014 Oct;90(4):435-9. doi: 10.1016/j.contraception.2014.04.014. Epub 2014 May 4.
OBJECTIVE(S): Interest has increased regarding the issue of contraception in transplant recipients. The purpose of this study was to assess birth control selection and the role of contraceptive counseling sessions in female kidney transplant (KT) and liver transplant (LT) recipients.
A cross-sectional single-center survey study of 217 female organ recipients (KT, 137 and LT, 80), aged 18-45 years, met the study criteria. Patients were asked 43 questions regarding their pre- and posttransplantation use of contraceptive methods, birth control awareness, contraception counseling and the factors determining the selection of effective contraception (hormonal contraception, intrauterine devices and female sterilization).
Thirty-three percent (5/15) of patients who had undergone the transplantation within 1 year prior to study inclusion were unaware of the necessity to use contraception. Both of the groups studied did not differ significantly in terms of the rates of pre- and posttransplantation consultations on effective contraception (KT: 26% vs. 34%; p=0.153 and LT 38% vs. 35%; p=0.729). Effective posttransplantation contraception was used by one in three patients, as indicated by posttransplantation consultations (KT: 30% vs. LT: 29%; p=0.910). The following factors affected the posttransplantation use of effective contraception: the presence of posttransplantation counseling on effective contraception [odds ratio (OR): 6.67; 95% confidence interval (CI): 2.12-20.1] and infrequent sexual activity prior to transplantation (OR: 0.56; 95% CI: 0.35-0.89).
CONCLUSION(S): The selection of effective contraception in KT and LT recipients remain suboptimal. Despite the low numbers of women who received contraceptive counseling in this study, consultation was nonetheless associated with choosing an effective method of contraception.
Current literature and data regarding contraception among female organ transplant recipients remain limited and are predominantly limited to a single population. The purpose of the study was to assess the level of satisfaction and the reasons underlying birth control selection in female kidney and LT recipients.
移植受者的避孕问题越来越受到关注。本研究的目的是评估女性肾移植（KT）和肝移植（LT）受者的避孕方式选择以及避孕咨询的作用。
一项针对217名年龄在18至45岁之间符合研究标准的女性器官受者（137名肾移植受者和80名肝移植受者）的单中心横断面调查研究。询问了患者43个关于移植前后避孕方法使用、避孕意识、避孕咨询以及决定选择有效避孕措施（激素避孕、宫内节育器和女性绝育）的因素的问题。
在纳入研究前1年内接受移植的患者中，33%（5/15）不知道有必要使用避孕措施。两组在移植前后有效避孕咨询率方面无显著差异（肾移植组：26%对34%；p = 0.153；肝移植组：38%对35%；p = 0.729）。根据移植后咨询情况，三分之一的患者使用了有效的移植后避孕措施（肾移植组：30%对肝移植组：29%；p = 0.910）。以下因素影响移植后有效避孕措施的使用：存在关于有效避孕的移植后咨询[优势比（OR）：6.67；95%置信区间（CI）：2.12 - 20.1]以及移植前性活动不频繁（OR：0.56；95%CI：0.35 - 0.89）。
肾移植和肝移植受者有效避孕措施的选择仍不理想。尽管本研究中接受避孕咨询的女性数量较少，但咨询与选择有效的避孕方法相关。
目前关于女性器官移植受者避孕的文献和数据仍然有限，且主要局限于单一人群。本研究的目的是评估女性肾移植和肝移植受者的满意度水平以及避孕选择背后的原因。
