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Meireles Castro Maia E, Autran Coelho Peixoto R, Aparecida Falbo Guazzelli C. Choice and factors associated to the use of contraceptive methods among postpartum women: A prospective cohort study. Eur J Obstet Gynecol Reprod Biol 2024; 298:1-5. [PMID: 38705006 DOI: 10.1016/j.ejogrb.2024.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/20/2024] [Accepted: 04/28/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES To assess women's contraceptive preferences in the immediate postpartum period and identify factors associated with use of their desired contraceptive method six months later. MATERIAL AND METHODS This prospective cohort study included women ≤48 h after delivery at a single public Brazilian hospital. The women's interview took place in two different momentsbefore hospital discharge (in-person interview) and six months after delivery (by telephone contact). For data collection and management, we used the REDCap electronic tool. Univariate and multivariate analyses (unadjusted and adjusted Odds Ratio and 95 % confidence intervals) were used to identify factors associated with higher use of their desired contraceptive method six months after delivery. RESULTS A total of 294 women (166 adolescents) were included. Initial contraceptive preferences were especially intrauterine devices (IUDs) (39.1 %), implants (33.0 %) and injectable hormonal contraceptives (17.0 %). Six months later, 42.5 % (n = 125) were using their desired contraceptive method. Younger age, white race and contraceptive initiation prior to hospital discharge were associated with use of their desired contraceptive at six months. CONCLUSION Long-acting reversible contraception (LARC) methods were the most desired contraceptives among women after delivery. Providing and initiating free contraception prior to discharge from a birthing unit is important with regard to use of their desired method.
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Affiliation(s)
| | - Raquel Autran Coelho Peixoto
- Department of Women's, Child and Adolescent Health at the Faculty of Medicine of the Federal University of Ceará, Rua Professor Costa Mendes, 1608, ZIP code 60430-140, Fortaleza, Brazil
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Engström E, Målqvist M, Niemeyer Hultstrand J. Family planning practices and women's impression of the reproductive life plan in Eswatini. SEXUAL & REPRODUCTIVE HEALTHCARE 2022; 32:100723. [PMID: 35413607 DOI: 10.1016/j.srhc.2022.100723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 02/15/2022] [Accepted: 03/27/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Family planning is limited and unplanned pregnancies are common in Eswatini. The Reproductive Life Plan (RLP) is a counselling tool to improve pregnancy planning. Mentor mothers, i.e. community health workers, were trained in using an adapted RLP and introduced it into family planning discussions with their clients. This study evaluates the clients' impression of the RLP and investigates their family planning practices. METHOD Data were collected in 2018 from anonymous questionnaires filled out by the clients: mothers or pregnant women aged 15-44 years. The questionnaire comprised 20 questions on demographic background, fertility desires, pregnancy planning as well as quality and perceived need for family planning support. Chi-square tests or Fisher's exact test were used for group comparisons. RESULTS 199 women were included. Most women (74%) chose the option that family planning discussions using the RLP had helped them 'very much'. A majority also had a perceived need for these discussions as 70% wanted to have more support from their mentor mother and 92% wanted more information about family planning. Women with lower educational level and younger women wanted more support compared to women with higher educational level and older women (p < 0.001 and p = 0.028). The unmet need for family planning was 22%. CONCLUSION The introduction of the RLP used by mentor mothers was well received among women but most of them requested more family planning support. Using the RLP may help women in this context achieve their reproductive goals.
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Affiliation(s)
- Ellinor Engström
- Department of Women's and Children's Health, Uppsala University, Sweden
| | - Mats Målqvist
- Department of Women's and Children's Health, Uppsala University, Sweden
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Zhu W, Zhang J, Yuan X, Liu X, Zhang Z, Mao Y, Feng Y, Yue A, Sun J, Wen C, Xu J, Shen Y, Che Y, Du J. Whole-exome sequencing reveals novel candidate single nucleotide variations for preventing adverse effects of levonorgestrel implantation. Pharmacogenomics 2021; 22:1185-1199. [PMID: 34783250 DOI: 10.2217/pgs-2021-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To identify novel genes associated with adverse effects of levonorgestrel (LNG) implants based on comparative whole-exome sequencing. Materials & methods: A cohort comprising 104 participants, including 52 controls and 52 women with LNG-related adverse effects, was recruited. Seven cases and eight controls were selected for whole-exome sequencing. We verified 13 single nucleotide variations (SNVs) related with integrin-mediated signaling pathway and cell proliferation using the MassARRAY platform. Results: Finally, we screened 49 cases and 52 controls for analyses. Two SNVs (rs7255721 and rs1042522) were located in ADAMTS10 and TP53, respectively, and significantly different between two groups. These two SNVs lead to changes in protein structure and physicochemical parameters. Conclusion: Here, we defined two pathogenic mutations related to adverse LNG effects.
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Affiliation(s)
- Weiqiang Zhu
- NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical & Pharmaceutical Technologies), Medical School, Fudan University, Shanghai 200032, China
| | - Junxian Zhang
- Department of Family Planning, Maternal & Child Health Care Hospital of Xinjiang Uygur Autonomous Region, Xinjiang 830001, China
| | - Xuelian Yuan
- Hami Central Hospital, Xinjiang Medical University, Xinjiang 830099, China
| | - Xiaoli Liu
- Chongqing Health Center for Women & Children, Chongqing 400010, China
| | - Zhaofeng Zhang
- NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical & Pharmaceutical Technologies), Medical School, Fudan University, Shanghai 200032, China
| | - Yanyan Mao
- NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical & Pharmaceutical Technologies), Medical School, Fudan University, Shanghai 200032, China
| | - Ying Feng
- Department of Family Planning, Maternal & Child Health Care Hospital of Xinjiang Uygur Autonomous Region, Xinjiang 830001, China
| | - Ailing Yue
- Hami Central Hospital, Xinjiang Medical University, Xinjiang 830099, China
| | - Junjie Sun
- Chongqing Health Center for Women & Children, Chongqing 400010, China
| | - Chuan Wen
- Hami Central Hospital, Xinjiang Medical University, Xinjiang 830099, China
| | - Jianhua Xu
- NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical & Pharmaceutical Technologies), Medical School, Fudan University, Shanghai 200032, China
| | - Yupei Shen
- NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical & Pharmaceutical Technologies), Medical School, Fudan University, Shanghai 200032, China
| | - Yan Che
- NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical & Pharmaceutical Technologies), Medical School, Fudan University, Shanghai 200032, China
| | - Jing Du
- NHC Key Lab of Reproduction Regulation (Shanghai Institute for Biomedical & Pharmaceutical Technologies), Medical School, Fudan University, Shanghai 200032, China
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