Emily M Godfrey1, Sheila Mody2, Malaika R Schwartz3, Sonya L Heltshe4, Jennifer L Taylor-Cousar5, Raksha Jain6, Sandra Sufian7, Tatiana Josephy8, Moira L Aitken9. 1. Department of Family Medicine and Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA. Electronic address: godfreye@uw.edu. 2. Division of Family Planning, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, CA, USA. 3. Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, USA. 4. Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Washington School of Medicine, Cystic Fibrosis Foundation Therapeutics Development Network, Seattle Children s Research Institute, Seattle, WA, USA. 5. Departments of Medicine and Pediatrics, Divisions of Pulmonary, Critical Care and Sleep Medicine and Pediatric Pulmonary Medicine, National Jewish Health, Denver, CO, USA. 6. Internal Medicine, Pulmonary and Critical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA. 7. Departments of Medical Education and of Disability and Human Development, University of Illinois at Chicago College of Medicine and College of Applied Health Sciences, Chicago, IL, USA. 8. Department of Family Medicine and Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA. 9. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Abstract
OBJECTIVES: To examine contraceptive use, pregnancy intention and the association of hormonal contraceptive type with adverse health outcomes among women with cystic fibrosis (CF). STUDY DESIGN: We recruited 150 women with CF, ages 18-49 from three adult CF programs to complete an online survey regarding their pregnancy and contraceptive use history. Survey findings were merged with retrospective clinical information from the CF Foundation Patient Registry (CFFPR). We used descriptive analyses to report contraceptive method and pregnancy frequencies, and logistic regression to examine the association between contraceptive method type and adverse health outcomes. RESULTS: Combined hormonal contraceptives were the most commonly used methods (42%), followed by condoms (34%), and long-acting reversible contraceptives methods (27%). Thirty-three percent (n = 50) reported ever being pregnant, half of whom reported having at least one unplanned pregnancy. We found no significant association for mucoid Pseudomonas aeruginosa infection among progestin-only (aOR 1.53, 95% CI 0.07-32.2) and estrogen-containing hormonal contraceptive users (aOR 3.9, 95 % CI 0.20-76.5). Risk of osteoporosis was elevated among women with CF who used depot-medroxyprogesterone acetate compared to non-users (OR 5.36, 95% CI 1.00-29.12). CONCLUSIONS: Both contraceptive use and unplanned pregnancy among women with CF are common. Associations between hormonal contraceptive use and adverse pulmonary or bone outcomes among women with CF are inconclusive due to the study s small sample size. Larger studies are warranted. IMPLICATIONS: Women with CF should be informed about the risks and benefits of contraceptives in the context of their disease. CFFPR data capturing contraceptive method use may be the most efficient way to elucidate the association of hormonal contraceptives on disease in women with CF.
OBJECTIVES: To examine contraceptive use, pregnancy intention and the association of hormonal contraceptive type with adverse health outcomes among women with cystic fibrosis (CF). STUDY DESIGN: We recruited 150 women with CF, ages 18-49 from three adult CF programs to complete an online survey regarding their pregnancy and contraceptive use history. Survey findings were merged with retrospective clinical information from the CF Foundation Patient Registry (CFFPR). We used descriptive analyses to report contraceptive method and pregnancy frequencies, and logistic regression to examine the association between contraceptive method type and adverse health outcomes. RESULTS: Combined hormonal contraceptives were the most commonly used methods (42%), followed by condoms (34%), and long-acting reversible contraceptives methods (27%). Thirty-three percent (n = 50) reported ever being pregnant, half of whom reported having at least one unplanned pregnancy. We found no significant association for mucoid Pseudomonas aeruginosa infection among progestin-only (aOR 1.53, 95% CI 0.07-32.2) and estrogen-containing hormonal contraceptive users (aOR 3.9, 95 % CI 0.20-76.5). Risk of osteoporosis was elevated among women with CF who used depot-medroxyprogesterone acetate compared to non-users (OR 5.36, 95% CI 1.00-29.12). CONCLUSIONS: Both contraceptive use and unplanned pregnancy among women with CF are common. Associations between hormonal contraceptive use and adverse pulmonary or bone outcomes among women with CF are inconclusive due to the study s small sample size. Larger studies are warranted. IMPLICATIONS: Women with CF should be informed about the risks and benefits of contraceptives in the context of their disease. CFFPR data capturing contraceptive method use may be the most efficient way to elucidate the association of hormonal contraceptives on disease in women with CF.
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