Kazerooni Rashid, Blake Ashley, Thai Julia
Veterans Affairs San Diego Healthcare System, San Diego, CA, USA UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, CA, USA
Veterans Affairs San Diego Healthcare System, San Diego, CA, USA UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, CA, USA.
Ann Pharmacother. 2015 Dec;49(12):1284-90. doi: 10.1177/1060028015607825. Epub 2015 Sep 28.
Pregnancy rates in veterans are an understudied phenomenon.
The objective of this study was to identify predictors of pregnancy within 1 year of starting hormonal contraception among female veterans.
This was a retrospective, cohort study of female veterans from Veterans Affairs facilities within Southern California and Nevada, who newly started hormonal contraception (pill, patch, or ring only) between October 2008 and September 2012. Pregnancy was defined as any event corresponding to a pregnant state using ICD-9 codes. Patients were followed for 1 year post-initiation. Multivariate logistic regression analysis was performed.
The final analysis included a total of 2166 patients. Approximately 5.9% (n = 127) of patients became pregnant during follow-up. Increased odds of pregnancy were associated with the following: mental health disease (odds ratio [OR] 1.69, 95% confidence interval [CI] 1.15-2.58), lowest socioeconomic quintile (OR 1.50, 95% CI 1.05-2.09), and Christian faith (OR 1.69, 95% CI 1.31-2.41). Age groups 25 to 34 years (OR 0.55, 95% CI 0.38-0.92] and 35 to 44 years (OR 0.32, 95% CI 0.06-0.64) were both associated with decreased odds of pregnancy versus age group 18 to 24 years.
This study successfully identified several predictors of pregnancy in female veterans starting a pill, patch, or ring form of hormonal contraception. Female veterans in the lowest socioeconomic quintile, aged 18 to 24 years, diagnosed with a mental health disorder, and of Christian faith were found to be at significantly higher odds of a pregnancy. Identification of these at-risk populations may help clinicians and policy makers choose strategies to identify which patients could benefit the most from more effective long-acting reversible contraception therapy.
退伍军人的怀孕率是一个研究较少的现象。
本研究的目的是确定女性退伍军人开始激素避孕后1年内怀孕的预测因素。
这是一项对南加州和内华达州退伍军人事务设施中的女性退伍军人进行的回顾性队列研究，这些女性在2008年10月至2012年9月期间新开始使用激素避孕（仅口服避孕药、避孕贴片或阴道环）。怀孕定义为使用ICD - 9编码对应怀孕状态的任何事件。患者在开始使用后随访1年。进行多变量逻辑回归分析。
最终分析共纳入2166例患者。约5.9%（n = 127）的患者在随访期间怀孕。怀孕几率增加与以下因素相关：精神疾病（优势比[OR] 1.69，95%置信区间[CI] 1.15 - 2.58）、社会经济最低五分位数（OR 1.50，95% CI 1.05 - 2.09）和基督教信仰（OR 1.69，95% CI 1.31 - 2.41）。25至34岁年龄组（OR 0.55，95% CI 0.38 - 0.92）和35至44岁年龄组（OR 0.32，95% CI 0.06 - 0.64）与18至24岁年龄组相比，怀孕几率均降低。
本研究成功确定了开始使用口服避孕药、避孕贴片或阴道环形式激素避孕的女性退伍军人怀孕的几个预测因素。发现社会经济最低五分位数、年龄在18至24岁、被诊断患有精神疾病且为基督教信仰的女性退伍军人怀孕几率显著更高。识别这些高危人群可能有助于临床医生和政策制定者选择策略，以确定哪些患者能从更有效的长效可逆避孕治疗中获益最多。
