In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 5 ( 2023-5-3), p. e0268872-
Abstract:
Pregnancies among women with chronic disease are associated with poor maternal and fetal outcomes. There is a need to understand how women use or don’t use contraception across their reproductive years to better inform the development of preconception care strategies to reduce high risk unintended pregnancies, including among women of older reproductive age. However, there is a lack of high-quality longitudinal evidence to inform such strategies. We examined patterns of contraceptive use among a population-based cohort of reproductive aged women and investigated how chronic disease influenced contraceptive use over time. Methods and findings Contraceptive patterns from 8,030 women of reproductive age from the Australian Longitudinal Study on Women’s Health (1973–78 cohort), who were at potential risk of an unintended pregnancy were identified using latent transition analysis. Multinomial mixed-effect logistic regression models were used to evaluate the relationship between contraceptive combinations and chronic disease. Contraception non-use increased between 2006 and 2018 but was similar between women with and without chronic disease (13.6% vs. 12.7% among women aged 40–45 years in 2018). When specific contraceptive use patterns were examined over time, differences were found for women with autoinflammatory diseases only. These women had increased odds of using condom and natural methods (OR = 1.20, 95% CI = 1.00, 1.44), and sterilisation and other methods (OR = 1.61, 95% CI = 1.08, 2.39) or no contraception (OR = 1.32, 95% CI = 1.04, 1.66), compared to women without chronic disease using short-acting methods and condoms. Conclusion Potential gaps in the provision of appropriate contraceptive access and care exist for women with chronic disease, particularly for women diagnosed with autoinflammatory conditions. Development of national guidelines as well as a clear coordinated contraceptive strategy that begins in adolescence and is regularly reviewed during care management through their main reproductive years and into perimenopause is required to increase support for, and agency among, women with chronic disease.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0268872
DOI:
10.1371/journal.pone.0268872.g001
DOI:
10.1371/journal.pone.0268872.t001
DOI:
10.1371/journal.pone.0268872.t002
DOI:
10.1371/journal.pone.0268872.t003
DOI:
10.1371/journal.pone.0268872.t004
DOI:
10.1371/journal.pone.0268872.t005
DOI:
10.1371/journal.pone.0268872.s001
DOI:
10.1371/journal.pone.0268872.s002
DOI:
10.1371/journal.pone.0268872.s003
DOI:
10.1371/journal.pone.0268872.s004
DOI:
10.1371/journal.pone.0268872.s005
DOI:
10.1371/journal.pone.0268872.s006
DOI:
10.1371/journal.pone.0268872.s007
DOI:
10.1371/journal.pone.0268872.s008
DOI:
10.1371/journal.pone.0268872.s009
DOI:
10.1371/journal.pone.0268872.s010
DOI:
10.1371/journal.pone.0268872.r001
DOI:
10.1371/journal.pone.0268872.r002
DOI:
10.1371/journal.pone.0268872.r003
DOI:
10.1371/journal.pone.0268872.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
Bookmarklink