Abstract
BACKGROUND: Women with diabetes mellitus who delay pregnancy until glycemic control is achieved experience lower rates of adverse pregnancy outcomes. OBJECTIVE: To compare rates of provision of contraceptive services among women with diabetes mellitus and women without chronic medical conditions. DESIGN: A retrospective cohort study of 459,181 women aged 15-44 who had continuous membership and pharmacy benefits in a managed care organization in Northern California between January 2006 and June 2007. Rates of documented provision of contraceptive counseling, prescriptions, and services were compared between women with diabetes and women without chronic medical conditions. RESULTS: Among 8,182 women with diabetes and 122,921 women without any chronic conditions, women with diabetes were less likely than women without a chronic condition to have documented receipt of any contraceptive counseling, prescriptions, or services (47.8% vs 62.0%, p < 0.001). After controlling for age and race, women with diabetes were more likely to have undergone tubal sterilization compared to women without a chronic condition (OR = 1.41, 95% CI 1.30-1.54), but less likely to have received highly effective, reversible methods of contraception such as intrauterine contraception (OR = 0.68, 95% CI 0.61-0.75). In addition, more women with diabetes had undergone hysterectomy, which is rarely performed solely for contraceptive purposes. CONCLUSIONS: Women with diabetes were less likely to receive highly effective reversible contraception and more likely to undergo sterilization procedures. Increasing the use of highly effective reversible contraceptives may help diabetic women who want to retain their fertility to delay pregnancy until glycemic control is achieved.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 196-201 |
| Number of pages | 6 |
| Journal | Journal of General Internal Medicine |
| Volume | 27 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2012 |
| Externally published | Yes |
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Keywords
- Contraception
- Diabetes mellitus
- Preconception counseling
- Pregnancy
- Women
ASJC Scopus subject areas
- Internal Medicine
Cite this
Provision of contraceptive services to women with diabetes mellitus. / Schwarz, Eleanor; Postlethwaite, Debbie; Hung, Yun Yi; Lantzman, Eric; Armstrong, Mary Anne; Horberg, Michael A.
In: Journal of General Internal Medicine, Vol. 27, No. 2, 01.02.2012, p. 196-201.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Provision of contraceptive services to women with diabetes mellitus
AU - Schwarz, Eleanor
AU - Postlethwaite, Debbie
AU - Hung, Yun Yi
AU - Lantzman, Eric
AU - Armstrong, Mary Anne
AU - Horberg, Michael A.
PY - 2012/2/1
Y1 - 2012/2/1
N2 - BACKGROUND: Women with diabetes mellitus who delay pregnancy until glycemic control is achieved experience lower rates of adverse pregnancy outcomes. OBJECTIVE: To compare rates of provision of contraceptive services among women with diabetes mellitus and women without chronic medical conditions. DESIGN: A retrospective cohort study of 459,181 women aged 15-44 who had continuous membership and pharmacy benefits in a managed care organization in Northern California between January 2006 and June 2007. Rates of documented provision of contraceptive counseling, prescriptions, and services were compared between women with diabetes and women without chronic medical conditions. RESULTS: Among 8,182 women with diabetes and 122,921 women without any chronic conditions, women with diabetes were less likely than women without a chronic condition to have documented receipt of any contraceptive counseling, prescriptions, or services (47.8% vs 62.0%, p < 0.001). After controlling for age and race, women with diabetes were more likely to have undergone tubal sterilization compared to women without a chronic condition (OR = 1.41, 95% CI 1.30-1.54), but less likely to have received highly effective, reversible methods of contraception such as intrauterine contraception (OR = 0.68, 95% CI 0.61-0.75). In addition, more women with diabetes had undergone hysterectomy, which is rarely performed solely for contraceptive purposes. CONCLUSIONS: Women with diabetes were less likely to receive highly effective reversible contraception and more likely to undergo sterilization procedures. Increasing the use of highly effective reversible contraceptives may help diabetic women who want to retain their fertility to delay pregnancy until glycemic control is achieved.
AB - BACKGROUND: Women with diabetes mellitus who delay pregnancy until glycemic control is achieved experience lower rates of adverse pregnancy outcomes. OBJECTIVE: To compare rates of provision of contraceptive services among women with diabetes mellitus and women without chronic medical conditions. DESIGN: A retrospective cohort study of 459,181 women aged 15-44 who had continuous membership and pharmacy benefits in a managed care organization in Northern California between January 2006 and June 2007. Rates of documented provision of contraceptive counseling, prescriptions, and services were compared between women with diabetes and women without chronic medical conditions. RESULTS: Among 8,182 women with diabetes and 122,921 women without any chronic conditions, women with diabetes were less likely than women without a chronic condition to have documented receipt of any contraceptive counseling, prescriptions, or services (47.8% vs 62.0%, p < 0.001). After controlling for age and race, women with diabetes were more likely to have undergone tubal sterilization compared to women without a chronic condition (OR = 1.41, 95% CI 1.30-1.54), but less likely to have received highly effective, reversible methods of contraception such as intrauterine contraception (OR = 0.68, 95% CI 0.61-0.75). In addition, more women with diabetes had undergone hysterectomy, which is rarely performed solely for contraceptive purposes. CONCLUSIONS: Women with diabetes were less likely to receive highly effective reversible contraception and more likely to undergo sterilization procedures. Increasing the use of highly effective reversible contraceptives may help diabetic women who want to retain their fertility to delay pregnancy until glycemic control is achieved.
KW - Contraception
KW - Diabetes mellitus
KW - Preconception counseling
KW - Pregnancy
KW - Women
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UR - http://www.scopus.com/inward/citedby.url?scp=84856721258&partnerID=8YFLogxK
U2 - 10.1007/s11606-011-1875-6
DO - 10.1007/s11606-011-1875-6
M3 - Article
VL - 27
SP - 196
EP - 201
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
SN - 0884-8734
IS - 2
ER -