Harrison Margo S, Bunge-Montes Saskia, Rivera Claudia, Jimenez-Zambrano Andrea, Heinrichs Gretchen, Bolanos Antonio, Asturias Edwin, Berman Stephen, Sheeder Jeanelle
University of Colorado, Anschutz Medical Campus, Aurora, USA.
Fundación para la Salud Integral de los Guatemaltecos, Quetzaltenango, Guatemala.
Obstet Gynecol Res. 2021;4(2):131-139. doi: 10.26502/ogr062. Epub 2021 Jun 25.
We conducted a secondary analysis of a cluster-randomized trial to observe characteristics associated with women who chose to use long-acting reversible contraceptives (LARC) compared to those who chose a short-acting method 12 months after enrollment.
The trial studied four control and four intervention clusters where the intervention clusters were offered contraception at their 40-day routine postpartum visit; control clusters received standard care, which included comprehensive postpartum contraceptive counseling. Women were followed through twelve months postpartum.
The study enrolled 208 women; 94 (87.0%) were in the intervention group and 91 (91.0%) were in the control group. At twelve months, with 130 (70.3%) women using contraception at that time. 94 women (50.8%) were using a short acting method compared to 33 (17.9%) who chose a long-acting method, irrespective of cluster. In mixed effect regression modeling adjusted for cluster, characteristics associated with a reduced likelihood of choosing long-acting contraception in multivariate modeling included age (aRR 0.98 [0.96,0.99], p = 0.008) and any education (compared to no education; aRR 0.76 [0.60,0.95], p = 0.02). Women who were sexually active by their enrollment visit (40 days postpartum) were 30% more likely to opt for a long-acting method (aRR 1.30 [1.03,1.63], p = 0.03).
Older and more educated women were less likely to be using LARC a year after enrollment, while women with a history of early postpartum sexual activity were more likely to choose LARC.
我们对一项整群随机试验进行了二次分析，以观察与选择长效可逆避孕方法（LARC）的女性相比，选择短效避孕方法的女性在入组12个月后的相关特征。
该试验研究了4个对照整群和4个干预整群，干预整群在产后40天常规访视时提供避孕措施；对照整群接受标准护理，其中包括全面的产后避孕咨询。对女性进行产后12个月的随访。
该研究纳入了208名女性；干预组94名（87.0%），对照组91名（91.0%）。在12个月时，当时有130名（70.3%）女性使用避孕措施。94名女性（50.8%）使用短效避孕方法，相比之下，33名（17.9%）选择长效避孕方法，与整群无关。在针对整群进行调整的混合效应回归模型中，多变量模型中与选择长效避孕可能性降低相关的特征包括年龄（调整后风险比0.98 [0.96,0.99]，p = 0.008）和接受过任何教育（与未接受教育相比；调整后风险比0.76 [0.60,0.95]，p = 0.02）。在入组访视（产后40天）时已有性行为的女性选择长效避孕方法的可能性高30%（调整后风险比1.30 [1.03,1.63]，p = 0.03）。
年龄较大和受教育程度较高的女性在入组一年后使用LARC的可能性较小，而有产后早期性行为史的女性更有可能选择LARC。
