Hormonal Contraception and Diabetes

Pattern of contraceptive use among reproductive-aged women with diabetes and/or hypertension: findings from Bangladesh Demographic and Health Survey

BACKGROUND

The prevalence of chronic conditions such as diabetes and hypertension is increasing among reproductive-aged women in Bangladesh. However, the pattern of contraceptive use among this population remains unknown. We, therefore, explored the pattern of contraceptive use among reproductive-aged women with diabetes and/or hypertension in Bangladesh.

METHODS

We extracted and analysed data of 3,947 women from the 2017/18 Bangladesh Demographic and Health Survey. Women's pattern of contraceptive use was our outcome variable. We first classified the contraceptive using status as no method use, traditional method use (periodic abstinence, withdrawal, other traditional) and modern method use (pill, intra-uterine device, injections, male condom, female sterilization, male sterilization). We later classified these as (i) no contraceptive use vs any contraceptive use, (ii) traditional method or no use vs modern method use, (iii) traditional method vs modern method use. The explanatory variables were diagnosis of diabetes only, hypertension only or both diabetes and hypertension. The multilevel Poisson regression with robust variance was used to explore the associations.

RESULTS

The overall prevalence of contraceptive use was 68.0% (95% CI 66.3-69.7). The corresponding prevalences were 69.4% (95% CI 61.8-76.1) in women with diabetes only, 67.3% (95% CI 63.5-70.9) with hypertension only, and 62.0% (95% CI 52.8-70.4) in women having both diabetes and hypertension. The prevalence of modern methods of contraceptive use was lower (46.4%, 95% CI 37.4-55.6) and traditional methods use was higher (16.6%, 95% CI 13.8-16.8) in women who had both diabetes and hypertension than in women who did not have these conditions. The fully adjusted regression model showed that the prevalence of traditional method use was 31% (Prevalence ratio: 1.31, 95% CI 1.02-2.01) higher in women having both diabetes and hypertension compared with their counterparts who had none of these conditions.

CONCLUSION

In Bangladesh, women with both diabetes and hypertension were more likely to use traditional contraception methods. These women are likely to experience increased risks of unwanted pregnancies and associated adverse maternal and child health outcomes. Targeted policies and programs should be undertaken to promote modern contraceptive use among women living with both chronic conditions.