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糖尿病女性避孕:医学档案登记和处方的充分性 - 一项横断面研究。

Contraception in women with diabetes: adequacy of medical files registration and prescription - a cross-section study.

机构信息

Post-Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.

Universidade do Vale do Taquari (UNIVATES), Lajeado, Brazil.

出版信息

Endocrine. 2023 Jun;80(3):511-519. doi: 10.1007/s12020-023-03344-4. Epub 2023 Mar 13.

Abstract

OBJECTIVE

To describe the adequacy of diabetes mellitus (DM) patient's files registry regarding contraception method (CM), factors associated with lack of registry, and if prescription is in accordance with World Health Organization (WHO) eligibility criteria.

RESEARCH DESIGN AND METHODS

This cross-sectional study was developed in two phases: (1) electronic medical records of women with DM who attended the outpatient clinic of a university hospital were reviewed to identify women in reproductive age and to look for CM registration and (2) interviews regarding contraception use, comorbidities and chronic DM complications.

RESULTS

Among 1069 files analyzed, 313 women with DM in childbearing age were identified. Out of those, 55.3% had a CM registered. Age >40 years, non-white skin color, and ≤11 years of education were associated with no registration. Of the 270 women interviewed, 201 (74.4%) were using CM. Out of the 69 patients not on CM, 51 fertile patients were at risk of an unplanned pregnancy (18.8% of the sample). The most frequently used method was oral hormonal (combined: 34.3%; progestin-only: 17.9%), and 67 (33.3%) were using an inadequate method (WHO eligibility category 3/4).

CONCLUSION

One third of women with DM are in childbearing age. Older age, non-white skin color, and lower education level were associated with lack of CM registration. One-third of respondents were using CM inappropriate for their clinical condition and one-fifth were at risk for an unplanned pregnancy. So, improvements in family planning for women with DM should be instituted.

摘要

目的

描述糖尿病(DM)患者档案中关于避孕方法(CM)的登记情况,以及缺乏登记的相关因素,以及处方是否符合世界卫生组织(WHO)的资格标准。

研究设计和方法

这项横断面研究分为两个阶段进行:(1)回顾了在大学医院门诊就诊的 DM 女性的电子病历,以确定处于生育期的女性,并寻找 CM 登记情况;(2)对避孕方法的使用、合并症和慢性 DM 并发症进行访谈。

结果

在分析的 1069 份档案中,确定了 313 名处于生育年龄的 DM 女性。其中,55.3%有 CM 登记。年龄>40 岁、非白色皮肤、教育程度≤11 年与未登记有关。在接受访谈的 270 名女性中,有 201 名(74.4%)正在使用 CM。在未使用 CM 的 69 名患者中,有 51 名有生育能力的患者有意外怀孕的风险(占样本的 18.8%)。最常使用的方法是口服激素(复方:34.3%;孕激素仅:17.9%),有 67 名(33.3%)使用的方法不合适(WHO 适宜性类别 3/4)。

结论

三分之一的 DM 女性处于生育年龄。年龄较大、非白色皮肤和较低的教育水平与 CM 登记的缺乏有关。三分之一的受访者使用的 CM 方法不适合其临床情况,五分之一的人有意外怀孕的风险。因此,应改善 DM 女性的计划生育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d04/10010636/b9c2fdceffa0/12020_2023_3344_Fig1_HTML.jpg

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