Patel Darshan P, Williams Letitia, Warner Lee, O'Neil Mary E, Aston Kenneth, Carrell Douglas T, Grigorescu Violanda, Jamieson Denise J, Gannon John R, Eisenberg Michael L, Walsh Thomas J, Hotaling James M
Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Transl Androl Urol. 2018 Jul;7(Suppl 3):S264-S270. doi: 10.21037/tau.2018.04.15.
To assess postpartum use of secondary contraception with vasectomy within Pregnancy Risk Assessment Monitoring System (PRAMS).
Secondary contraception and type of method used were assessed among married women reporting partner vasectomy 4 months after a recent live birth in female residents of 15 US states and New York City who participated in the 2007-2011 PRAMS.
Between 2007 and 2011, 1,004 married women who had a recent live birth participating in PRAMS reported they and their partners relied on vasectomy for postpartum contraception. Among these couples, 57.8% reported not using additional forms of contraception postpartum. Of those reporting additional contraception, condoms were most commonly used (50.0%), followed by oral contraceptive pills (26.5%), and withdrawal (9.5%). Multivariable modeling showed that use of secondary contraception was twice as high among women reporting a second birth versus women reporting a fourth or higher birth [adjusted prevalence odds ratio (POR) =2.0 (1.1-3.2)]. No other sociodemographic characteristics (maternal age, maternal race, parental education, household income) were significantly associated with use of secondary contraception with vasectomy.
Most couples within PRAMS reporting partner vasectomy as postpartum contraception did not use secondary contraception in the months immediately after vasectomy, and, of those who did, most relied on less effective methods. Clinicians need to better understand reasons for limited use of secondary contraception with vasectomy to improve counseling strategies for reducing unintended pregnancy.
在妊娠风险评估监测系统（PRAMS）中评估输精管结扎术后的产后二级避孕措施使用情况。
在参与2007 - 2011年PRAMS的美国15个州和纽约市的女性居民中，对近期活产后4个月报告伴侣已接受输精管结扎术的已婚妇女进行二级避孕措施及所使用方法类型的评估。
2007年至2011年期间，1004名参与PRAMS且近期有活产的已婚妇女报告称她们及其伴侣依靠输精管结扎术进行产后避孕。在这些夫妇中，57.8%报告产后未使用其他避孕方式。在报告使用其他避孕措施的人群中，最常使用的是避孕套（50.0%），其次是口服避孕药（26.5%），以及体外射精（9.5%）。多变量模型显示，报告生育第二胎的女性使用二级避孕措施的比例是报告生育第四胎或更高胎次女性的两倍[调整后的患病率比值比（POR）=2.0（1.1 - 3.2）]。没有其他社会人口学特征（产妇年龄、产妇种族、父母教育程度、家庭收入）与输精管结扎术后二级避孕措施的使用有显著关联。
在PRAMS中，大多数报告伴侣输精管结扎术作为产后避孕措施的夫妇在输精管结扎术后的几个月内未使用二级避孕措施，而在使用的人群中，大多数依靠效果较差的方法。临床医生需要更好地了解输精管结扎术后二级避孕措施使用受限的原因，以改进减少意外妊娠的咨询策略。
