Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Rama IV Road, Pathum Wan, Bangkok, 10330, Thailand.
Chula Data Management Center, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
Reprod Health. 2024 Jun 6;21(1):80. doi: 10.1186/s12978-024-01803-3.
Unintended pregnancies can adversely affect maternal health, preventable through timely postpartum contraception. During the COVID-19 pandemic, family planning services were constrained by policies that curtailed outpatient visits. We investigated the prevalence of postpartum contraceptive initiation at King Chulalongkorn Memorial Hospital (KCMH) during January to June 2020, comparing with the same period in 2019, and identified factors associated with such initiation.
We reviewed the medical records of 4506 postpartum women who delivered at KCMH during the study period. Logistic regression was conducted to test the association between early COVID-19 phase deliveries and post-partum long acting reversible contraception (LARC) initiation including copper intrauterine devices, levonorgestrel intrauterine systems, contraceptive implants, and progestogen-only injectable contraceptives.
A total of 3765 women (83.6%), of whom 1821 delivered during the pandemic and 1944 during the historical cohort period, were included in this study. The proportion of women who initiated non-permanent modern contraceptives at six weeks postpartum was comparable between the COVID-19 (73.4%) and historical cohort (75.3%) (p = 0.27) periods. The proportion of women who initiated LARC at six weeks postpartumwas comparable between the historical cohort period (22.5%) and the COVID-19 (19.7%) (p = 0.05) period. Accessing a six-week postpartum check-up was independently associated with LARC initiation, of which the adjusted odds ratio (OR) (95% confidence interval) was 3.01 (2.26 to 4.02).
Our findings demonstrated that accessing postpartum care significantly associate with the use of LARC. The data suggest the strong influence of postpartum check-ups in facilitating the adoption of effective contraception, emphasizing the need for accessible postpartum care to sustain maternal health during health crises.
意外怀孕会对产妇健康产生不良影响，而通过及时的产后避孕可以预防这种情况。在 COVID-19 大流行期间，计划生育服务受到限制门诊就诊政策的限制。我们调查了 2020 年 1 月至 6 月期间在朱拉隆功国王纪念医院（KCMH）产后避孕的起始率，与 2019 年同期进行了比较，并确定了与这种起始相关的因素。
我们回顾了研究期间在 KCMH 分娩的 4506 名产后妇女的病历。使用逻辑回归检验了早期 COVID-19 阶段分娩与产后长效可逆避孕（LARC）的起始之间的关联，包括铜宫内节育器、左炔诺孕酮宫内节育系统、避孕植入物和孕激素仅注射避孕药。
共有 3765 名妇女（83.6%），其中 1821 名在大流行期间分娩，1944 名在历史队列期间分娩，纳入本研究。在产后六周时，非永久性现代避孕药的起始比例在 COVID-19（73.4%）和历史队列（75.3%）（p=0.27）期间相似。在产后六周时，LARC 的起始比例在历史队列期间（22.5%）和 COVID-19（19.7%）（p=0.05）期间相似。产后 6 周检查的就诊与 LARC 的起始独立相关，调整后的优势比（OR）（95%置信区间）为 3.01（2.26 至 4.02）。
我们的研究结果表明，获得产后护理与 LARC 的使用显著相关。数据表明，产后检查在促进有效避孕措施的采用方面具有强大的影响力，强调在卫生危机期间需要获得可及的产后护理，以维持产妇健康。
