Department of Clinical Pharmacy, Ziekenhuisgroep Twente, Almelo, The Netherlands.
Department of Pharmacotherapy, Epidemiology and Economics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
Obes Surg. 2019 Dec;29(12):4029-4035. doi: 10.1007/s11695-019-04084-z.
Reproductive-aged women are, according to American and European guidelines, recommended to avoid pregnancy for 12-24 months after bariatric surgery. Oral contraceptives may have suboptimal efficacy after malabsorptive bariatric procedures.
The aim of this study was to assess contraceptive use pre- and postoperatively in women who underwent bariatric surgery in two obesity clinics in The Netherlands. Also, the recall of contraceptive and pregnancy counseling was investigated.
A validated questionnaire was performed among women aged 18-45 years who underwent bariatric surgery from October 2017 through August 2018.
In total, 230 women were eligible for final analysis. Postoperatively, 60% used safe contraception, 16.1% unsafe contraception, and 23.9% no contraception. In this study, 43.7% of women using a potential unsafe contraceptive method preoperatively switched to a safe method of contraception postoperatively (p < 0.0001). Only 62.6% of women confirmed to have received contraceptive counseling, mainly preoperatively. The odds ratio for receiving contraceptive counseling and using safe contraceptive methods compared with not receiving contraceptive counseling was 2.20 (95% CI, 1.27-3.79; p = 0.005). Eighty-three percent confirmed that they have received counseling regarding delaying a pregnancy, and 52.6% were familiar with the recommendation to avoid a pregnancy for 24 months postoperatively.
In our study, 60% of women are using safe contraception postoperatively. Contraceptive counseling is suboptimal as 62.6% recall receiving counseling. Those who confirmed receiving counseling were more likely to use safe contraception after bariatric surgery. More counseling and monitoring in the postoperative and in the outpatient setting is recommended.
根据美国和欧洲的指南，建议生殖期女性在接受减重手术后 12-24 个月内避免怀孕。在进行吸收不良型减重手术后，口服避孕药的效果可能欠佳。
本研究旨在评估在荷兰两家肥胖症诊所接受减重手术的女性在手术前后的避孕措施使用情况，并调查其对避孕和妊娠咨询的回忆情况。
对 2017 年 10 月至 2018 年 8 月期间接受减重手术的年龄在 18-45 岁的女性进行了一项经过验证的问卷调查。
共有 230 名女性符合最终分析条件。术后，60%的女性使用了安全的避孕措施，16.1%使用了不安全的避孕措施，23.9%未采取避孕措施。在这项研究中，术前使用潜在不安全避孕方法的女性中有 43.7%在术后转为使用安全的避孕方法（p<0.0001）。只有 62.6%的女性确认接受了避孕咨询，主要是在术前。与未接受避孕咨询相比，接受避孕咨询并使用安全避孕方法的女性的优势比为 2.20（95%置信区间，1.27-3.79；p=0.005）。83%的女性确认她们已接受过关于推迟怀孕的咨询，52.6%的女性熟悉术后 24 个月内避免怀孕的建议。
在我们的研究中，术后 60%的女性使用安全的避孕措施。避孕咨询效果不佳，只有 62.6%的人回忆起接受过咨询。那些确认接受过咨询的人在接受减重手术后更有可能使用安全的避孕措施。建议在术后和门诊环境中加强咨询和监测。
