University of Massachusetts Chan Medical School, Worcester, MA, USA.
Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School/UMass Memorial Health, Worcester, MA, USA.
Womens Health (Lond). 2023 Jan-Dec;19:17455057231175311. doi: 10.1177/17455057231175311.
The first wave of the COVID-19 pandemic was associated with restricted access to reproductive care including delayed abortion and female sterilization procedures, in addition to altered maternity care experiences. Given high rates of unintended and short-interval pregnancies in the United States in general and negative obstetric outcomes specifically associated with COVID-19, access to all effective pregnancy prevention methods during the pandemic was crucial.
To investigate changes in contraception utilization rates prior to delivery discharge, at outpatient postpartum visits, and at 10 weeks' postpartum, at the largest healthcare system in Central Massachusetts, during the first wave of the COVID-19 pandemic (15 March to 15 May 2020), compared to the same period in 2019.
Retrospective cohort review.
Compared perinatal individuals (n = 495) who received prenatal care and delivered at UMass Memorial Medical Center from mid-March to mid-May in both 2019 (non-pandemic) and 2020 (COVID-19 pandemic). Receipt of contraception prior to delivery discharge and at outpatient postpartum visit was estimated and compared between the two time periods using the Chi-square test for categorical variables (or Fisher's exact test when cell counts were < 5) and Student's -test for continuous variables. Multivariable logistic regression was performed to adjust for confounders.
The proportion of individuals who used long-acting reversible contraception before delivery discharge was 4% in 2019 and 13% in 2020 ( = 0.01). Modes of outpatient postpartum visit contraception did not vary from 2019 to 2020, ( = 0.06). Overall, there were no differences in contraception utilization rates at 10 weeks' postpartum from 2019 to 2020, ( = 0.50).
Compared to a year prior, immediate postpartum long-acting reversible contraception use increased during the first wave of the COVID-19 pandemic, while overall contraception use at 10 weeks' postpartum remained unchanged. The evaluation of contraceptive use during the most restrictive time of COVID-19 pandemic can help identify opportunities to increase access to effective contraception, such as the immediate postpartum period prior to hospital discharge.
第一波 COVID-19 大流行期间，美国生殖保健服务的可及性受到限制，包括推迟堕胎和女性绝育手术，同时产妇保健服务的体验也发生了改变。鉴于美国普遍存在意外怀孕和短间隔怀孕的高比率，以及 COVID-19 与不良产科结局之间存在关联，因此在大流行期间获得所有有效的妊娠预防方法至关重要。
在马萨诸塞州中部最大的医疗保健系统中，调查 COVID-19 大流行第一波期间（2020 年 3 月 15 日至 5 月 15 日），与 2019 年同期相比，分娩出院时、门诊产后就诊时和产后 10 周时的避孕措施使用率的变化。
回顾性队列研究。
比较 2019 年（非大流行时期）和 2020 年（COVID-19 大流行时期）在马萨诸塞州中部 UMass Memorial 医疗中心接受产前护理并分娩的 495 名围产期个体。使用卡方检验（分类变量）或 Fisher 确切检验（当细胞计数 < 5 时）比较两个时期分娩出院前和门诊产后就诊时的避孕措施使用情况，并使用 Student's -检验比较连续变量。采用多变量逻辑回归调整混杂因素。
2019 年分娩出院前使用长效可逆避孕措施的个体比例为 4%，而 2020 年为 13%（ = 0.01）。从 2019 年到 2020 年，门诊产后就诊时的避孕模式没有差异（ = 0.06）。总体而言，2019 年和 2020 年产后 10 周的避孕措施使用率没有差异（ = 0.50）。
与一年前相比，COVID-19 大流行第一波期间，分娩后立即使用长效可逆避孕措施的比例增加，而产后 10 周的总体避孕措施使用率保持不变。评估 COVID-19 大流行最严格时期的避孕措施使用情况，可以帮助确定增加有效避孕措施可及性的机会，例如分娩出院前的产后即刻时期。
