Department of Family Medicine and Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA.
Division of Family Planning, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, CA, USA.
Contraception. 2020 Jun;101(6):420-426. doi: 10.1016/j.contraception.2020.02.006. Epub 2020 Feb 26.
To examine contraceptive use, pregnancy intention and the association of hormonal contraceptive type with adverse health outcomes among women with cystic fibrosis (CF).
We recruited 150 women with CF, ages 18-49 from three adult CF programs to complete an online survey regarding their pregnancy and contraceptive use history. Survey findings were merged with retrospective clinical information from the CF Foundation Patient Registry (CFFPR). We used descriptive analyses to report contraceptive method and pregnancy frequencies, and logistic regression to examine the association between contraceptive method type and adverse health outcomes.
Combined hormonal contraceptives were the most commonly used methods (42%), followed by condoms (34%), and long-acting reversible contraceptives methods (27%). Thirty-three percent (n = 50) reported ever being pregnant, half of whom reported having at least one unplanned pregnancy. We found no significant association for mucoid Pseudomonas aeruginosa infection among progestin-only (aOR 1.53, 95% CI 0.07-32.2) and estrogen-containing hormonal contraceptive users (aOR 3.9, 95 % CI 0.20-76.5). Risk of osteoporosis was elevated among women with CF who used depot-medroxyprogesterone acetate compared to non-users (OR 5.36, 95% CI 1.00-29.12).
Both contraceptive use and unplanned pregnancy among women with CF are common. Associations between hormonal contraceptive use and adverse pulmonary or bone outcomes among women with CF are inconclusive due to the study s small sample size. Larger studies are warranted.
Women with CF should be informed about the risks and benefits of contraceptives in the context of their disease. CFFPR data capturing contraceptive method use may be the most efficient way to elucidate the association of hormonal contraceptives on disease in women with CF.
研究囊性纤维化 (CF) 女性的避孕措施使用情况、妊娠意愿，以及激素避孕类型与不良健康结局的相关性。
我们从三个成人 CF 项目中招募了 150 名年龄在 18-49 岁的 CF 女性，让她们完成一份关于妊娠和避孕措施使用史的在线调查。调查结果与 CF 基金会患者登记处 (CFFPR) 的回顾性临床信息合并。我们使用描述性分析报告避孕方法和妊娠频率，并使用逻辑回归检验避孕方法类型与不良健康结局之间的关联。
联合激素避孕药是最常用的方法（42%），其次是避孕套（34%）和长效可逆避孕方法（27%）。33%（n=50）的人报告曾怀孕，其中一半人报告至少有一次意外怀孕。我们发现，在使用单纯孕激素（aOR 1.53，95%CI 0.07-32.2）和含雌激素的激素避孕药的女性中，黏液性铜绿假单胞菌感染没有显著相关性。与未使用者相比，使用 depot-medroxyprogesterone 醋酸酯的 CF 女性骨质疏松症的风险升高（OR 5.36，95%CI 1.00-29.12）。
CF 女性的避孕措施使用和意外妊娠都很常见。由于研究样本量小，CF 女性使用激素避孕药与不良肺部或骨骼结局之间的相关性尚无定论。需要进行更大规模的研究。
应向 CF 女性告知避孕措施在其疾病背景下的风险和益处。CFFPR 数据捕捉避孕方法的使用可能是阐明 CF 女性激素避孕药对疾病影响的最有效方法。
