Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Fertil Steril. 2022 Jul;118(1):168-179. doi: 10.1016/j.fertnstert.2022.03.013. Epub 2022 May 28.
To assess the awareness, knowledge, and misconceptions of young people regarding long-acting reversible contraceptives (LARCs).
We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines of MEDLINE-Ovid, Embase, and Cumulative Index to Nursing and Allied Health Literature. A random-effects meta-analysis was performed with formal tests for heterogeneity and publication bias. Additional outcomes were summarized using thematic analysis.
Not applicable.
PATIENT(S): Adolescents and young adults (aged 12-25 years) with a uterus.
INTERVENTION(S): Not applicable.
MAIN OUTCOME MEASURE(S): Patient-reported outcomes related to awareness, knowledge, and misconceptions of LARCs (including intrauterine devices, subdermal implants, and injections) were analyzed.
RESULT(S): Of the 4,077 database citations, we included 40 studies encompassing 10,470 adolescents and young people. Twenty studies were eligible for meta-analysis. The pooled prevalence described that only 65.0% (95% confidence interval [CI], 51-78) of participants were aware of at least 1 type of LARC (I = 100). The meta-regression noted that the region, risk of bias, gravidity, sexual history, previous LARC experience, and postsecondary education were not associated with awareness. There were numerous misconceptions regarding eligibility, safety, and usage. Notably, 62% (95% CI, 20-91) did not understand that LARCs could be used in nulliparous individuals, and 37% (95% CI, 21-56) believed that LARCs could cause infertility.
CONCLUSION(S): There are notable knowledge gaps among adolescents and young people regarding LARCs, such as eligibility criteria, the reversibility of long-acting options, and misconceptions regarding infertility. Clinicians should specifically counsel regarding the suitability for LARCs in nulliparous populations and that LARCs do not cause infertility.
评估年轻人对长效可逆避孕措施（LARC）的认知、知识和误解。
我们按照《系统评价和荟萃分析的首选报告项目》的指导原则，对 MEDLINE-Ovid、Embase 和 Cumulative Index to Nursing and Allied Health Literature 进行了系统评价。采用随机效应荟萃分析，并进行了异质性和发表偏倚的正式检验。其他结局则采用主题分析进行总结。
不适用。
有子宫的青少年和年轻成年人（年龄 12-25 岁）。
不适用。
分析与 LARC（包括宫内节育器、皮下埋植剂和注射剂）认知、知识和误解相关的患者报告结局。
在 4077 条数据库引用中，我们纳入了 40 项研究，共纳入了 10470 名青少年和年轻人。20 项研究符合荟萃分析的条件。汇总的流行率表明，只有 65.0%（95%置信区间[CI]，51-78）的参与者知晓至少 1 种 LARC（I²=100）。元回归表明，地区、偏倚风险、生育次数、性史、既往 LARC 经验和高等教育与认知无关。关于资格、安全性和使用方法存在许多误解。值得注意的是，62%（95%CI，20-91）的人不理解 LARC 可用于未育个体，37%（95%CI，21-56）的人认为 LARC 会导致不孕。
青少年和年轻人对 LARC 存在明显的知识差距，例如资格标准、长效选择的可逆性以及关于不孕的误解。临床医生应特别针对 LARC 在未育人群中的适用性进行咨询，并告知他们 LARC 不会导致不孕。
