Department of Public Health, University of Helsinki, Faculty of Medicine, Helsinki, Finland
Department of Public Health, University of Helsinki, Faculty of Medicine, Helsinki, Finland.
BMJ Open. 2020 Oct 15;10(10):e040072. doi: 10.1136/bmjopen-2020-040072.
Sociodemographic and mental health characteristics are associated with contraceptive choices. We aimed to describe the sociodemographic, reproductive and mental health characteristics of all fertile-aged women in Finland who used hormonal contraception (HC) in 2017.
A nationwide, register-based study.
All women living in Finland in 2017; data from the Care Register of Health Care, Medical Birth Register, Population Register Centre, Prescription Centre, Register of Induced Abortions.
All women aged 15-49 with one redeemed HC prescription in 2017 (n=294 356), and a same-sized, age-matched and residence-matched, control group of non-users.
Rates of HC use; associations between HC use and mental disorders, sociodemographic and reproductive characteristics.
25.8% of women aged 15-49 years used HC. Women with the lowest socioeconomic levels had lower odds of using HC than women with upper-level statuses (OR, 95% CI students: 0.97, 0.94 to 0.99; entitled to pension: 0.66, 0.63 to 0.69; other: 0.87, 0.85 to 0.89; unknown: 0.90, 0.85 to 0.90). Women with the highest education (secondary: 1.46, 1.43 to 1.48; tertiary: 1.64, 1.58 to 1.70; academic: 1.60, 1.56 to 1.63) and income (second quarter: 1.57, 1.54 to 1.60; third quarter: 1.85, 1.82 to 1.89; fourth quarter: 2.01, 1.97 to 2.06), and unmarried women had higher odds of using HC than women with the lowest education and income levels, and married (0.61, 0.60 to 0.62), divorced (0.86, 0.84 to 0.88), widowed (0.73, 0.65 to 0.83) or other marital status women (0.26, 0.22 to 0.30).Parous women (0.70, 0.69 to 0.71), those with previous induced abortion(s) (0.91, 0.89 to 0.92) or recent eating (0.68, 0.62 to 0.75) or personality (0.89, 0.79 to 0.97) disorders had lower odds of HC use. Absolute risk differences between women with and without mental disorders ranged from 3.1% (anxiety disorders) to 10.1% (eating disorders).
A quarter of the fertile-aged women use HC in Finland. Sociodemographic disparities persist in relation to HC use, although of small effect size. HC use is less common among women suffering from severe to moderate psychiatric disorders, especially eating disorders.
社会人口学和心理健康特征与避孕方法的选择有关。我们旨在描述芬兰所有在 2017 年使用激素避孕（HC）的育龄妇女的社会人口学、生殖和心理健康特征。
一项全国范围内基于登记的研究。
2017 年居住在芬兰的所有女性；数据来自保健记录登记处、医疗出生登记处、人口登记中心、处方中心和人工流产登记处。
所有年龄在 15-49 岁之间、2017 年有一份 HC 处方的女性（n=294356），以及一组年龄、居住地匹配、未使用 HC 的对照组女性。
HC 使用率；HC 使用与精神障碍、社会人口学和生殖特征之间的关联。
年龄在 15-49 岁的女性中，有 25.8%使用了 HC。社会经济地位最低的女性使用 HC 的可能性低于地位较高的女性（学生：0.97，0.94 至 0.99；有资格领取养老金：0.66，0.63 至 0.69；其他：0.87，0.85 至 0.89；未知：0.90，0.85 至 0.90）。接受最高教育（中等：1.46，1.43 至 1.48；高等：1.64，1.58 至 1.70；学术：1.60，1.56 至 1.63）和收入（第二季度：1.57，1.54 至 1.60；第三季度：1.85，1.82 至 1.89；第四季度：2.01，1.97 至 2.06）的女性，以及未婚女性使用 HC 的可能性高于接受教育程度和收入水平最低的女性以及已婚（0.61，0.60 至 0.62）、离婚（0.86，0.84 至 0.88）、丧偶（0.73，0.65 至 0.83）或其他婚姻状况（0.26，0.22 至 0.30）的女性。多产妇女（0.70，0.69 至 0.71）、有过人工流产史（0.91，0.89 至 0.92）或近期饮食（0.68，0.62 至 0.75）或人格（0.89，0.79 至 0.97）障碍的妇女使用 HC 的可能性较低。有精神障碍的女性与无精神障碍的女性之间的绝对风险差异范围为 3.1%（焦虑障碍）至 10.1%（饮食障碍）。
芬兰四分之一的育龄妇女使用 HC。尽管影响程度较小，但与 HC 使用相关的社会人口学差异仍然存在。患有严重至中度精神障碍的女性，尤其是饮食障碍患者，使用 HC 的可能性较低。
