Mazzoni Sara E, O'Reilly Treter Maggie, Hyer Jennifer, Peña Rachel, Rhoades Galena K
Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA.
Department of Psychology, University of Denver, Denver, Colorado, USA.
Womens Health Rep (New Rochelle). 2023 Mar 27;4(1):148-153. doi: 10.1089/whr.2022.0104. eCollection 2023.
We aimed to evaluate the impact of an antenatal group healthy relationship education program on the postpartum use of long-acting reversible contraception (LARC).
This is a planned subgroup analysis of a larger randomized controlled trial. Pregnant and newly parenting women were randomized to either group healthy relationship education, "MotherWise," or no additional services. An evidence-based healthy relationship education program and individual case management sessions were provided. The program did not include any prenatal care or contraception counseling. This subgroup analysis included those participants with a nonanomalous gestation randomized at <40 weeks who received care and delivered at a single safety-net hospital and were discharged home with a live infant(s).
From September 2, 2016 to December 21, 2018, 953 women were randomized in the larger trial; 507 met inclusion criteria for this study; 278 randomized to program and 229 controls. Participants were mostly young, parous, Hispanic, publicly insured women. Participants randomized to program were more likely to take a prescription medicine and be delivered through cesarean; there were not any other significant differences in baseline, antenatal, or perinatal outcomes. Those randomized to program were more likely to be discharged home with immediate postpartum LARC in place (odds ratio [OR] 1.87; confidence interval [CI] 1.17-3.00), and more likely to be using LARC at the postpartum visit (OR 2.19; CI 1.34-3.56).
Antenatal group healthy relationship education provided separately from prenatal care is associated with a twofold increase in the use of postpartum LARC.
ClinicalTrials.gov NCT02792309; https://clinicaltrials.gov/ct2/show/NCT02792309?term=NCT02792309&draw=2&rank=1.
我们旨在评估一项产前群体健康关系教育项目对产后长效可逆避孕方法（LARC）使用情况的影响。
这是一项对一项更大规模随机对照试验进行的预设亚组分析。怀孕及初为人母的女性被随机分为接受群体健康关系教育（“明智妈妈”项目）组或不接受额外服务组。提供了一项基于证据的健康关系教育项目及个案管理服务。该项目不包括任何产前护理或避孕咨询。此亚组分析纳入了那些妊娠正常、在孕40周前随机分组、在一家安全网医院接受护理并分娩且带着活产婴儿出院回家的参与者。
从2016年9月2日至2018年12月21日，在更大规模试验中有953名女性被随机分组；507名符合本研究的纳入标准；278名被随机分入项目组，229名作为对照组。参与者大多为年轻、经产、西班牙裔、有公共保险的女性。被随机分入项目组的参与者更有可能服用处方药且通过剖宫产分娩；在基线、产前或围产期结局方面没有其他显著差异。被随机分入项目组的参与者更有可能在产后立即带着LARC出院回家（比值比[OR]1.87；置信区间[CI]1.17 - 3.00），且在产后访视时更有可能正在使用LARC（OR 2.19；CI 1.34 - 3.56）。
与产前护理分开提供的产前群体健康关系教育与产后LARC使用量增加两倍相关。
ClinicalTrials.gov NCT02792309；https://clinicaltrials.gov/ct2/show/NCT02792309?term=NCT02792309&draw=2&rank=1
