Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Australia.
Geohealth Laboratory, Dasman Diabetes Institute, 15462, Kuwait City, Kuwait.
Clin Res Cardiol. 2024 Aug;113(8):1151-1170. doi: 10.1007/s00392-024-02472-9. Epub 2024 Jul 10.
To address the lack of clarity regarding contraceptive counselling and uptake of contraception among women with cardiovascular disease (CVD), this study aimed to conduct a systematic review and meta-analysis on contraceptive counselling and the subsequent uptake of contraception among women with CVD. A search across six databases identified 1228 articles, with 11 studies (2580 participants) included. The pooled prevalence of contraceptive counselling was 63%, varying from 36 to 94% in individual studies. Inconsistent delivery and documentation of counselling were noted, along with a lack of knowledge about pregnancy complications and misconceptions regarding CVD severity. For contraceptive uptake (n = 5), the pooled prevalence was 64% (95% confidence interval, 45 to 82%). Women with CVD were also found to use less effective methods as well as methods not recommended for their condition (e.g., combined hormonal methods among participants with absolute or relative contraindications). Improving contraceptive counselling and choices for women with CVD can not only enhance knowledge and decision-making for women with CVD in line with their reproductive goals and preferences but reduce high-risk unintended pregnancies and adverse pregnancy outcomes.
为了解决心血管疾病 (CVD) 女性在避孕咨询和避孕措施使用方面的不明确问题，本研究旨在对 CVD 女性的避孕咨询及其后续避孕措施使用情况进行系统评价和荟萃分析。通过对六个数据库进行搜索，共确定了 1228 篇文章，其中包括 11 项研究（2580 名参与者）。避孕咨询的总体流行率为 63%，在个别研究中从 36%到 94%不等。研究中注意到咨询的提供和记录不一致，并且对妊娠并发症的认识不足，对 CVD 严重程度存在误解。对于避孕措施的使用（n=5），总体流行率为 64%（95%置信区间，45%至 82%）。还发现 CVD 女性使用的方法效果较差，且不适合其病情（例如，有绝对或相对禁忌症的参与者中使用复方激素方法）。改善 CVD 女性的避孕咨询和选择不仅可以增强符合 CVD 女性生殖目标和偏好的知识和决策能力，还可以减少高风险的非意愿妊娠和不良妊娠结局。
