Contraceptive Use by Diabetic Women in the 2011-2013 National Survey for Family Growth Open Access

Koziol, Beata Gabriela (2016)

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As the incidence of obesity and diabetes increase in the United States steps should be taken to ensure at-risk women with these conditions are protected from unintended and mistimes pregnancies. The results of the 2011-2013 NSFG were analyzed to determine differences in contraceptive use between diabetic and non-diabetic women. Logistic models, adjusted for interaction between race/ethnicity and place of usual healthcare as well as for confounding by age, poverty, BMI, age at menarche, pregnancy intention, place of usual medical care, general health, and diabetes status, were utilized to predict odds of contraceptive use. Compared to non-diabetic women, diabetic women were significantly more likely to be older, black or Hispanic, and obese (P<0.0001). They were significantly more likely to have a usual place of healthcare but were less affluent. They also reached menarche at an earlier age, and reported worse general health (P<0.0001). Although a greater proportion of diabetic women reported sterilization as their primary contraceptive (39.3% vs 28.8%), there was no significant association between contraceptive method and disease status. No association was found between diabetes and contraceptive use, even after adjustment for interaction and confounding (OR 0.93 [0.37-2.34]). However, adjustment revealed a significant association between irregular healthcare and contraceptive nonuse (OR 0.31 [0.14-0.70]). It is imperative that both diabetic women and their providers are educated regarding the criteria established by the USMEC to provide guidelines for contraceptive use in women with medical comorbidities as many may erroneously believe that diabetic women cannot use effective, reversible forms of contraception.

Table of Contents

Background 1

Methods 3

Results 6

Discussion 8

Strengths and Limitations 8

Future Directions 10

References 12

Tables 14

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