Mahande Michael J, Sato Ryoko, Amour Caroline, Manongi Rachel, Farah Amina, Msuya Sia E, Elewonibi Bilikisu, Shah Iqbal
Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, P.O Box 2240, Moshi, Tanzania.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA.
Contracept Reprod Med. 2021 May 3;6(1):15. doi: 10.1186/s40834-021-00157-6.
Postpartum contraceptive discontinuation refers to cessation of use following initiation after delivery within 1 year postpartum. Discontinuation of use has been associated with an increased unmet need for family planning that leads to high numbers of unwanted pregnancies, unsafe abortion or mistimed births. There is scant information about contraceptive discontinuation and its predictors among postpartum women in Tanzania. This study aimed to determine predictors of contraception discontinuation at 3, 6, 12 months postpartum among women of reproductive age in Arusha city and Meru district, Tanzania.
This was an analytical cross-sectional study which was conducted in two district of Arusha region (Arusha city and Meru district respectively). A multistage sampling technique was used to select 13 streets of the 3 wards in Arusha City and 2 wards in Meru District. A total of 474 women of reproductive age (WRAs) aged 16-44 years residing in the study areas were included in this analysis. Data analysis was performed using STATA version 15. Odds ratios (ORs) with 95% confidence interval (CI) for the factors associated with contraceptives discontinuation (at 3, 6 and 12 moths) were estimated in a multivariable logistic regression model.
Overall, discontinuation rate for all methods at 3, 6, and 12 months postpartum was 11, 19 and 29% respectively. It was higher at 12 months for Lactational amenorrhea, male condoms and injectables (76, 50.5 and 36%, respectively). Women aged 40-44 years had lower odds of contraceptive discontinuation at 3 months as compare to those aged 16 to 19 years. Implants and pills users had also lower odds of contraceptive discontinuation compared to injectable users at 3, 6 and 12 months respectively.
Lactational amenorrhea, male condoms and injectables users had the highest rates of discontinuation. Women's age and type of method discontinued were independently associated with postpartum contraceptive discontinuation. Addressing barriers to continue contraceptive use amongst younger women and knowledge on method attributes, including possible side-effects and how to manage complications is warranted.
产后避孕药停用是指产后1年内开始使用避孕药后又停止使用。停用避孕药与计划生育需求未得到满足的情况增加有关，这会导致大量意外怀孕、不安全堕胎或生育时机不当。关于坦桑尼亚产后妇女避孕药停用情况及其预测因素的信息很少。本研究旨在确定坦桑尼亚阿鲁沙市和梅鲁区育龄妇女产后3个月、6个月和12个月时避孕药停用的预测因素。
这是一项分析性横断面研究，在阿鲁沙地区的两个区（分别为阿鲁沙市和梅鲁区）进行。采用多阶段抽样技术，从阿鲁沙市3个病房的13条街道和梅鲁区的2个病房中选取样本。本分析纳入了居住在研究区域内的474名年龄在16 - 44岁的育龄妇女（WRAs）。使用STATA 15版进行数据分析。在多变量逻辑回归模型中估计与避孕药停用（产后3个月、6个月和12个月时）相关因素的比值比（ORs）及95%置信区间（CI）。
总体而言，产后3个月、6个月和12个月时所有避孕方法的停用率分别为11%、19%和29%。哺乳期闭经法、男用避孕套和注射用避孕药在12个月时的停用率较高（分别为76%、50.5%和36%）。与16至19岁的妇女相比，40 - 44岁的妇女在产后3个月时避孕药停用的几率较低。与注射用避孕药使用者相比，植入剂和口服避孕药使用者在产后3个月、6个月和12个月时避孕药停用的几率也较低。
哺乳期闭经法、男用避孕套和注射用避孕药使用者的停用率最高。妇女年龄和停用的避孕方法类型与产后避孕药停用独立相关。有必要解决年轻女性继续使用避孕药的障碍以及关于避孕方法特性的知识，包括可能的副作用以及如何处理并发症。
