Contraceptive Use among Women with Prediabetes and Diabetes in a US National Sample

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Citation

Britton, Laura E.; Hussey, Jon M.; Berry, Diane C.; Crandell, Jamie L.; Brooks, Jada L.; & Bryant, Amy G. (2019). Contraceptive Use among Women with Prediabetes and Diabetes in a US National Sample. Journal of Midwifery & Women's Health, 64(1), 36-45. PMCID: PMC6351213

Abstract

INTRODUCTION: Although elevated blood glucose is associated with adverse maternal and fetal health outcomes, evidence suggests that women with diabetes may not be receiving comprehensive reproductive health care, including family planning and preconception care. Using a population-based sample, we evaluated the relationship between contraceptive use and biomarker-identified diabetes.
METHODS: This cross-sectional study used data from 5548 women in the nationally representative National Longitudinal Study of Adolescent to Adult Health (Add Health) from 2007 to 2009. Women were aged 24 to 32 years, sexually active with men, and not pregnant. Hemoglobin A1C identified prediabetes and diabetes from blood specimens. The primary outcome was most effective contraception used in the past year: more effective (sterilization, intrauterine device, implant, combined hormonal methods, or injectable), less effective (condoms, diaphragms, spermicides, natural family planning, or withdrawal), or none. Multinomial regression models were adjusted for race and ethnicity, education, insurance, health care access, and body mass index.
RESULTS: Of the women with diabetes, 37.6% used more effective contraception, 33.6% less effective contraception, and 28.8% none. Women with diabetes had higher odds of using no contraception, rather than more effective contraception, than women with normoglycemia (adjusted odds ratio [aOR], 1.90; 95% CI, 1.25-2.87). Women with diabetes who were undiagnosed had greater odds of using less effective contraception, rather than more effective contraception, compared with those who were diagnosed (aOR 3.39; 95% CI, 1.44-7.96). Contraceptive use did not differ between women with prediabetes and normoglycemia.
DISCUSSION: Less effective contraceptive methods were commonly used by women with diabetes. Midwives and other women's health care providers can support women with diabetes to reach their pregnancy goals by providing preconception care and family planning.

URL

http://dx.doi.org/10.1111/jmwh.12936

Reference Type

Journal Article

Year Published

2019

Journal Title

Journal of Midwifery & Women's Health

Author(s)

Britton, Laura E.
Hussey, Jon M.
Berry, Diane C.
Crandell, Jamie L.
Brooks, Jada L.
Bryant, Amy G.

Article Type

Regular

PMCID

PMC6351213

Data Set/Study

National Longitudinal Study of Adolescent to Adult Health (Add Health)

Continent/Country

United States of America

State

Nonspecific

Sex/Gender

Women

ORCiD

Hussey - 0000-0003-1799-9845
Britton - 0000-0003-4051-3751