Fry Kevin M, Gerhardt Cynthia A, Ash Jerry, Zaidi Ali N, Garg Vidu, McBride Kim L, Fitzgerald-Butt Sara M
Center for Cardiovascular and Pulmonary Research, The Research Institute, Nationwide Children's Hospital, Columbus, Ohio.
Center for Biobehavioral Health, The Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio.
J Adolesc Health. 2015 Apr;56(4):396-401. doi: 10.1016/j.jadohealth.2014.12.013.
Because of the increased risks associated with unplanned pregnancy for males and females with congenital heart disease (CHD), we investigated sexual intercourse and contraception use in these adolescents and young adults (AYA) and compared the same with national and state population data.
We recruited 337 AYA with structural CHD aged 15-25 years (Mage = 19 years, standard deviation = 3.1; 53% male, 84% white) from an outpatient cardiology clinic to participate in a larger study assessing genetic knowledge and health behaviors. Cumulative lifetime prevalence of adolescent (aged 15-18 years) sexual intercourse was compared with the 2011 Youth Risk Behavior Surveillance System and the 2007 Ohio Youth Risk Behavior Survey. Cumulative lifetime prevalence of young adult (aged 19-25 years) sexual intercourse and contraception use at last sex were compared with the 2006-2008 National Survey of Family Growth.
Reported rates of ever having sexual intercourse, 26% of adolescents and 74% of young adults with CHD, were significantly lower than general population rates (47% and 86% respectively; p < .001). Similar to the general population, 77% of previously sexually active young adults with CHD reported using at least one effective method of contraception at last intercourse, whereas 25% used dual effective methods and 23% used no effective method.
Lower rates of ever having sexual intercourse in this population suggest that the psychosexual development of AYA with CHD may lag behind their peers. As nearly one in four participants reported using no effective method of contraception, health care providers should increase discussions of contraception with males and females with CHD.
由于先天性心脏病（CHD）患者意外怀孕会给男性和女性带来更高风险，我们调查了这些青少年及青年（AYA）的性行为和避孕措施使用情况，并将其与全国及州人口数据进行比较。
我们从一家门诊心脏病诊所招募了337名年龄在15 - 25岁的患有结构性CHD的AYA（平均年龄 = 19岁，标准差 = 3.1；53%为男性，84%为白人），以参与一项评估遗传知识和健康行为的更大规模研究。将青少年（15 - 18岁）性行为的累积终生患病率与2011年青少年风险行为监测系统以及2007年俄亥俄州青少年风险行为调查结果进行比较。将青年（19 - 25岁）性行为的累积终生患病率以及最近一次性行为时避孕措施的使用情况与2006 - 2008年全国家庭成长调查结果进行比较。
报告显示，患有CHD的青少年和青年中有过性行为的比例分别为26%和74%，显著低于一般人群的比例（分别为47%和86%；p < 0.001）。与一般人群相似，77%曾经有过性行为的患有CHD的青年报告在最近一次性行为时至少使用了一种有效的避孕方法，而25%使用了两种有效的方法，23%未使用任何有效的方法。
该人群中有过性行为的比例较低，这表明患有CHD的AYA的性心理发展可能落后于同龄人。由于近四分之一的参与者报告未使用任何有效的避孕方法，医疗保健提供者应增加与患有CHD的男性和女性关于避孕的讨论。
