Contraception: X最新文献

{"title":"Ultrasound assessment of postplacental copper intrauterine device position 6 months after placement during cesarean delivery","authors":"Elizabeth P. Gurney ,&nbsp;Arden McAllister,&nbsp;Britt Lang,&nbsp;Courtney A. Schreiber,&nbsp;Sarita Sonalkar","doi":"10.1016/j.conx.2020.100040","DOIUrl":"10.1016/j.conx.2020.100040","url":null,"abstract":"<div><h3>Objective</h3><p>The objective was to describe the sonographic position of copper intrauterine devices (IUDs) 6 months after insertion during cesarean delivery.</p></div><div><h3>Study design</h3><p>This prospective, observational study followed participants who received a copper IUD during cesarean delivery. We performed pelvic examination at 6 weeks and 6 months and sonography at 6 months to determine IUD position. Patients had additional examinations as needed to address complications.</p></div><div><h3>Results</h3><p>Sixty-nine participants provided outcomes through 6 months: 41 (59%) had correctly positioned IUDs, 21 (30%) had malpositioned intrauterine IUDs, 5 experienced expulsion (3 partial, 2 complete), and 2 had elective removal; 52 (75%) had missing strings. Missing strings at 6 weeks predicted an incorrect IUD position in 22 of 52 participants (positive predictive value 42%), and visible or palpable strings predicted a correct IUD position in 7 of 12 participants (negative predictive value 58%).</p></div><div><h3>Conclusion</h3><p>Although 59% of copper IUDs placed during cesarean were correctly positioned at 6 months, nearly one third were malpositioned.</p></div><div><h3>Implications</h3><p>Ultrasound may be indicated for patients receiving a copper IUD during cesarean delivery as checking IUD strings alone does not assure correct placement. Providers offering postpartum IUDs should ensure that appropriate processes for the evaluation and management of devices with missing strings or abnormal position are available to all patients regardless of insurance status.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100040"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38615956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive utility of unmet need on time to contraceptive adoption: a panel study of non-contracepting Ugandan women","authors":"Dana Sarnak ,&nbsp;Amy Tsui ,&nbsp;Fredrick Makumbi ,&nbsp;Simon P.S Kibira ,&nbsp;Saifuddin Ahmed","doi":"10.1016/j.conx.2020.100022","DOIUrl":"10.1016/j.conx.2020.100022","url":null,"abstract":"<div><h3>Objective</h3><p>The predictive utility of the unmet contraceptive need indicator is not well known, despite being recognized as a key family planning indicator for showing the extant demand for birth control. This study assesses the dynamic influence of unmet need on time to contraceptive adoption, as compared with that of contraceptive intentions and their concordance.</p></div><div><h3>Study design</h3><p>This observational study analyzed survey data, including a contraceptive calendar, reported by a panel of 747 non-contracepting, fecund and sexually active Ugandan women, first interviewed in a 2014 national survey and re-interviewed in 2018. We conducted descriptive, survival and multivariate Cox regression analysis of the influence of women's baseline measures of unmet need, self-reported intention to contracept and their concordance with time to adoption of modern contraception over 36 months.</p></div><div><h3>Results</h3><p>The study found women classified as having unmet need were slower to adopt contraception than those without unmet need, after adjustment for background covariates (aHR<!--> <!-->=<!--> <!-->0.79, 95% CI<!--> <!-->=<!--> <!-->0.57–1.10). Women intending future contraceptive use were significantly faster to adopt (aHR<!--> <!-->=<!--> <!-->1.45, 95% CI<!--> <!-->=<!--> <!-->1.22–1.73) than those not intending. Women with no unmet need but intending to use had the highest rate of adoption compared to those with no need and no intention to use (aHR<!--> <!-->=<!--> <!-->2.78, 95% CI<!--> <!-->=<!--> <!-->1.48–5.25).</p></div><div><h3>Conclusions</h3><p>The unmet need indicator underperforms in predicting future contraceptive adoption compared to contraceptive intentions, which merits further consideration as a complementary predictor of future use. Non-contracepting women with unmet need but no intention to use contraception in particular warrant programmatic attention.</p></div><div><h3>Implications</h3><p>A non-contracepting woman wanting to limit or space her births is defined as having unmet need, but little is known if she subsequently adopts contraception. By contrasting a woman's unmet need with her expressed intention to use, we offer reasons to further consider self-reported contraceptive intentions as a better predictor of adoption and the underlying latent demand for volitional regulation of fertility.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100022"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38059603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Interpersonal Quality of Family Planning Scale in a rural Indian setting","authors":"Nicole E. Johns ,&nbsp;Anvita Dixit ,&nbsp;Mohan Ghule ,&nbsp;Shahina Begum ,&nbsp;Madhusudana Battala ,&nbsp;Gennifer Kully ,&nbsp;Jay Silverman ,&nbsp;Christine Dehlendorf ,&nbsp;Anita Raj ,&nbsp;Sarah Averbach","doi":"10.1016/j.conx.2020.100035","DOIUrl":"10.1016/j.conx.2020.100035","url":null,"abstract":"<div><h3>Objectives</h3><p>The provision of high-quality family planning (FP) counseling can both enhance clients' experience of care and improve their ability to make and act on their contraceptive decisions. The Interpersonal Quality of Family Planning (IQFP) scale measures FP counseling quality and has been validated in the United States. We aimed to explore whether it remains appropriate for use in a low-/middle-income country (LMIC).</p></div><div><h3>Study design</h3><p>We surveyed 1201 nonsterilized married women ages 18–29 in Maharashtra, India, between September 2018 and June 2019. Respondents rated their FP provider from “poor” (1) to “excellent” (5) across 11 IQFP items. We assessed scale reliability via Cronbach's <em>α</em> test and used exploratory factor analysis to evaluate unidimensionality and regression models of plausibly related outcomes to assess construct validity.</p></div><div><h3>Results</h3><p>Five hundred four women (42%) had seen an FP provider within the past year, 491 (97%) of whom answered all items. Mean IQFP score was 2.62 out of 5 (SD 0.94, range 1–5). Scale reliability was high (<em>α</em> <!-->=<!--> <!-->0.97). Exploratory factor analyses support unidimensionality (all factor loadings &gt;<!--> <!-->0.4). A 1-point increase in average IQFP score was associated with nearly double the odds of current modern contraceptive use (adjusted odds ratio<!--> <!-->=<!--> <!-->1.73, 95% confidence interval<!--> <!-->=<!--> <!-->1.36–2.19).</p></div><div><h3>Conclusions</h3><p>The IQFP scale shows good reliability and construct validity in this context, and its use in LMIC settings should be broadly considered. A higher IQFP score was associated with greater odds of contraceptive use. The reported FP counseling quality was low, so future public health efforts should aim to increase counseling quality to better meet the needs of women in low-resource settings like rural India. Measurement tools like IQFP can support success evaluation of the quality of care provided by family planning programs.</p></div><div><h3>Implications</h3><p>The Interpersonal Quality of Family Planning scale is a useful tool in rural India, a different context than the one in which it was developed. Use of the IQFP scale should be considered in other low-/middle-income countries to better measure the quality of family planning care provided.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"2 ","pages":"Article 100035"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2020.100035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38264540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of self-injected DMPA-SC compared with health-worker-injected DMPA-IM in Senegal","authors":"Mercy Mvundura ,&nbsp;Laura Di Giorgio ,&nbsp;Chloe Morozoff ,&nbsp;Jane Cover ,&nbsp;Marguerite Ndour ,&nbsp;Jennifer Kidwell Drake","doi":"10.1016/j.conx.2019.100012","DOIUrl":"10.1016/j.conx.2019.100012","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate the cost-effectiveness of self-injected subcutaneous depot medroxyprogesterone acetate (DMPA-SC) compared to health-worker-administered intramuscular DMPA (DMPA-IM) in Senegal and to assess how including practice or demonstration injections in client self-injection training affects estimates.</p></div><div><h3>Study design</h3><p>We developed a decision-tree model with a 12-month time horizon for a hypothetical cohort of 100,000 injectable contraceptive users in Senegal. We used the model to estimate incremental costs per disability-adjusted life year (DALY) averted. The analysis derived model inputs from DMPA-SC self-injection continuation and costing research studies and peer-reviewed literature. We evaluated the cost-effectiveness from societal and health system perspectives and conducted one-way and probabilistic sensitivity analyses to test the robustness of results.</p></div><div><h3>Results</h3><p>Compared to health-worker-administered DMPA-IM, self-injected DMPA-SC could prevent 1402 additional unintended pregnancies and avert 204 maternal DALYs per year for this hypothetical cohort. From a societal perspective, self-injection costs less than health worker administration regardless of the training approach and is therefore dominant. From the health system perspective, self-injection is dominant compared to health worker administration if a one-page instruction sheet is used and one additional DMPA-SC unit is used for training and is cost-effective at $208 per DALY averted when two additional DMPA-SC units are used. Sensitivity analysis showed estimates were robust.</p></div><div><h3>Conclusions</h3><p>Self-injected DMPA-SC averted more pregnancies and DALYs and cost less from the societal perspective compared to health-worker-administered DMPA-IM and hence is dominant. Using fewer DMPA-SC units for practice or demonstration improves cost-effectiveness of self-injection from the health system perspective.</p></div><div><h3>Implications</h3><p>Evidence from Senegal shows that self-injection of DMPA-SC can be dominant or cost-effective from both health system and societal perspectives relative to DMPA-IM from health workers even if women practice injecting or health workers demonstrate with one or two DMPA-SC units. Evidence on whether practice or demonstration is required for client training would be useful.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"1 ","pages":"Article 100012"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2019.100012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38007178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in subcutaneous depot medroxyprogesterone acetate (DMPA-SC) use in Burkina Faso, the Democratic Republic of Congo and Uganda","authors":"Philip Anglewicz ,&nbsp;Pierre Akilimali ,&nbsp;Georges Guiella ,&nbsp;Patrick Kayembe ,&nbsp;Simon P.S. Kibira ,&nbsp;Fredrick Makumbi ,&nbsp;Amy Tsui ,&nbsp;Scott Radloff","doi":"10.1016/j.conx.2019.100013","DOIUrl":"10.1016/j.conx.2019.100013","url":null,"abstract":"<div><h3>Objectives</h3><p>Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is seen as a valuable innovation in family planning, but little is known about trends in DMPA-SC use or characteristics of users. Using data from Burkina Faso, the Democratic Republic of Congo (DRC) and Uganda, we measured trends in DMPA-SC and identified characteristics associated with DMPA-SC use.</p></div><div><h3>Study design</h3><p>We used repeated cross-sectional representative data collected between 2016 and 2019. First, we plotted trends in DMPA-SC use for all women and married women. Next, we presented the sociodemographic and family-planning-related characteristics of DMPA-SC users. Finally, we conducted weighted multivariate logistic regression analysis to examine how DMPA-SC users were different from women (1) using all other modern methods combined and (2) not using any modern method.</p></div><div><h3>Results</h3><p>DMPA-SC use increased monotonically in all three countries. Many DMPA-SC users were first-time users of modern contraception (54.5% in Burkina Faso, 34.6% in DRC, 50.7% in Uganda). Never-married women had lower odds than married women of using DMPA-SC (compared to other modern methods) in all three countries [Burkina Faso adjusted odds ratio (AOR) 0.40, 95% confidence interval (95% CI) 0.20–0.80; DRC AOR 0.31 95% CI 0.10–0.93; Uganda AOR 0.24; 95% CI 0.08–0.71]. Level of education was positively associated with DMPA-SC use (compared to no use) (Burkina Faso AOR 1.79; 95% CI 1.03–3.14; Uganda AOR 3.23; 95% CI 1.33–7.84).</p></div><div><h3>Conclusions</h3><p>DMPA-SC is a rapidly growing method in these settings. Despite the comparable levels of and increases in use for all three countries, the characteristics associated with DMPA-SC use generally differed across countries.</p></div><div><h3>Implications</h3><p>This is the first analysis of patterns of DMPA-SC use with representative data for African countries. Our results confirm that DMPA-SC is increasingly popular, although the profile of users varies across settings.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"1 ","pages":"Article 100013"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2019.100013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous vs. cyclic combined hormonal contraceptives for treatment of dysmenorrhea: a systematic review","authors":"Tiffany Damm ,&nbsp;Georgine Lamvu ,&nbsp;Jorge Carrillo ,&nbsp;Chensi Ouyang ,&nbsp;Jessica Feranec","doi":"10.1016/j.conx.2019.100002","DOIUrl":"10.1016/j.conx.2019.100002","url":null,"abstract":"<div><h3>Objective</h3><p>This systematic review aims to evaluate the benefits of oral continuous combined hormonal contraceptives (CHCs) in managing dysmenorrhea by comparing randomized controlled trials (RCTs) evaluating the efficacy of continuous vs. cyclic CHC use for the following outcomes: (a) reducing dysmenorrhea duration and frequency, (b) severity, (c) recurrence and (d) interference with daily activity.</p></div><div><h3>Study design</h3><p>Cochrane, PUBMED and Popline databases were searched from 1934 to 2018 for all relevant studies evaluating CHC for treatment of dysmenorrhea. A study was selected if it (a) compared continuous regimen vs. cyclic regimen of oral CHC, (b) measured dysmenorrhea as a primary or secondary outcome, (c) was an RCT and (d) was published in English. Due to differences in CHC used and outcome measurement, a systematic analysis of individual study results and a limited meta-analysis were conducted.</p></div><div><h3>Results</h3><p>Of 780 studies that were screened by title and abstract, 8 were included in the final analysis; 6 evaluated cyclic vs. continuous CHC, and 2 evaluated cyclic vs. extended/flexible CHC use. Quality of evidence was low for all outcome measures. Overall, compared to cyclic use, flexible/extended CHC resulted in 4 fewer days of dysmenorrhea. Studies revealed conflicting results for interference with daily activity, pain severity and pain recurrence. Side effects were few in both comparison groups.</p></div><div><h3>Conclusions</h3><p>Continuous or extended/flexible CHC use may reduce dysmenorrhea duration compared to cyclic regimen; however, more rigorous research is needed.</p></div><div><h3>Implications</h3><p>This systematic review shows that continuous CHC use may reduce dysmenorrhea duration compared to cyclic regimen, although the quality of evidence is low. Future double-blinded RCTs with more rigorous study design, consistent outcome measures and comprehensive outcome reporting are needed.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"1 ","pages":"Article 100002"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2019.100002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tideglusib, a prospective alternative to nonoxynol-9 contraceptive","authors":"Zhiting Chen ,&nbsp;Niyan Shu ,&nbsp;Yuzhu Wang ,&nbsp;Yiting Yang ,&nbsp;Zhiyu Shao ,&nbsp;Fang Tian ,&nbsp;Minjie Xia ,&nbsp;Zhikai Wang ,&nbsp;Xin Wang ,&nbsp;Xing Feng ,&nbsp;Xianliang Huang ,&nbsp;Weihua Li ,&nbsp;Heguo Yu ,&nbsp;Hua Diao","doi":"10.1016/j.conx.2019.100007","DOIUrl":"10.1016/j.conx.2019.100007","url":null,"abstract":"<div><h3>Objectives</h3><p>We aimed to evaluate the antifertility activity and vaginal irritation effects of tideglusib in vivo using rabbit models and to evaluate the cytotoxical effects of tideglusib to sperm, vaginal cells and vaginal bacteria (<em>L. acidophilus</em>) in vitro.</p></div><div><h3>Study design</h3><p>We treated female rabbits with vaginal tideglusib 1 mM, nonoxynol-9 (N-9) or vehicle control (Poloxamer 407). In experiment 1, we sacrificed females (<em>n</em> = 6 each) after 10 days of daily administration and assessed vaginal histological changes using Eckstein irritation score. In experiment 2, females (<em>n</em> = 9 each) received estradiol benzoate to induce ovulation 24 h prior to vaginal treatment followed by introduction of a fertile male. These females underwent necropsy at the 21st day to assess pregnancy status. In experiment 3, we used an HTM-TOX IVOS sperm motility analyzer and scanning electron microscopy (SEM) to evaluate the effect of tideglusib on human sperm samples. In experiment 4, we evaluated the effect of tideglusib on lactobacillus and vaginal cell growth in vitro.</p></div><div><h3>Results</h3><p>The total irritation score of tideglusib vs. N-9 was 3.4 ± 2.07 vs. 7.8 ± 3.82, p<!--> <!-->&lt;.05. The pregnancy rate of tideglusib, N-9 and control group was 11.1%, 0% and 88.9%, respectively. Tideglusib exhibited a dose-dependent spermostatic/spermicidal activity, and the minimum effective concentrations of tideglusib and N-9 were 8.724 ± 3.047 μM and 219.75 ± 41.78 μM, respectively. SEM and transmission electron microscopy revealed acrosomal membrane impairments caused by tideglusib. Tideglusib was much less toxic to vaginal cells and <em>L. acidophilus</em> than N-9 in vitro.</p></div><div><h3>Conclusions</h3><p>Evaluation using rabbit models indicated that tideglusib is a prospective spermicidal contraceptive with low vaginal irritation effects.</p></div><div><h3>Implications</h3><p>Tideglusib or tideglusib analogues may be a contraceptive with perspective to replace N-9. It is possible for a spermicide to balance spermicidal activity and vaginal/cervical irritation effects very well.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"1 ","pages":"Article 100007"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2019.100007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can we safely stop testing for Rh status and immunizing Rh-negative women having early abortions? A comparison of Rh alloimmunization in Canada and the Netherlands","authors":"Ellen R. Wiebe ,&nbsp;Mackenzie Campbell ,&nbsp;Abigail R.A. Aiken ,&nbsp;Arianne Albert","doi":"10.1016/j.conx.2018.100001","DOIUrl":"10.1016/j.conx.2018.100001","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this study was to compare Rh alloimmunization rates in two countries (Canada and the Netherlands) with completely different policies regarding abortion-related use of anti-D immunoglobulin to ultimately determine any benefit in use. In the Netherlands, the policy is to offer anti-D immunoglobulin to Rh-negative women having spontaneous abortions over 10 weeks 0 days gestation and induced abortions over 7 weeks 0 days. In Canada, it is recommended to offer all Rh-negative women having induced or spontaneous abortions anti-D immunoglobulin.</p></div><div><h3>Methods</h3><p>We used public databases to obtain the population data, the number of births, the abortion rates (the percentage of women having induced abortions in one year) and the Rh-negativity rates (percentage of Rh negative women) in Canada and the Netherlands. Both countries do routine prenatal blood screening and we obtained the rates of clinically significant antibodies from public databases.</p></div><div><h3>Results</h3><p>In nearly 2 million blood samples from pregnant women in both Canada and the Netherlands, the prevalence of clinically significant antibodies was statistically lower in the Netherlands: 4.21 (95% CI: 4.12 to 4.30) and 4.03 (95% CI: 3.93 to 4.12) per 1000, respectively. Canada and the Netherlands had small differences in rates of abortion (1.9 per 100 vs 1.2 per 100) and of Rh negativity (13.0% vs 14.5%).</p></div><div><h3>Conclusion</h3><p>Despite different anti-D Ig treatment policies, we found a similar prevalence of clinically significant perinatal antibodies among women in Canada and the Netherlands.</p></div><div><h3>Implications</h3><p>Our findings suggest that The Dutch policy of not treating Rh-negative women having spontaneous abortions under 10 weeks’ or induced abortions under 7 weeks’ gestation can be safely adopted by other countries.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"1 ","pages":"Article 100001"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2018.100001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49291431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cohort study to evaluate efficacy, safety and acceptability of a two-rod contraceptive implant during third, fourth and fifth year of product use in China","authors":"Y Che ,&nbsp;D Taylor ,&nbsp;D Luo ,&nbsp;LY Maldonado ,&nbsp;M Wang ,&nbsp;S Wevill ,&nbsp;H Vahdat ,&nbsp;X Han ,&nbsp;V Halpern ,&nbsp;L Dorflinger ,&nbsp;MJ Steiner","doi":"10.1016/j.conx.2019.100008","DOIUrl":"10.1016/j.conx.2019.100008","url":null,"abstract":"<div><h3>Objective</h3><p>Sino-implant (II) is a contraceptive implant approved for 4 years of use in China. We evaluated the contraceptive efficacy during the third, fourth and fifth year, and assessed additional pharmacokinetics (PK), safety, and acceptability endpoints.</p></div><div><h3>Study design</h3><p>We enrolled a cohort of 255 current Sino-Implant (II) users entering their third year and a second cohort of 243 users entering their fourth year. We followed these two cohorts for 12 and 24 months, respectively. To characterize PK endpoints (i.e. levonorgestrel (LNG), sex hormone binding globulin and free LNG index) over 5 years, we collected blood samples in a subset of 50 participants we followed during the third, fourth and fifth year. We also enrolled small cohorts (n = 20) of Sino-implant (II) users entering their sixth month and second year and followed them each for up to 6 months. Our primary efficacy measures were the pregnancy Pearl Indices during Year 3 and 4. Secondary objectives included assessments of PK, safety, acceptability and efficacy in the fifth year.</p></div><div><h3>Results</h3><p>We recorded four pregnancies, with a higher pregnancy rate during Year 3 [1.34 (95% CI: 0.28–3.93)] than Year 4 [0.44 (95% CI: 0.01–2.47)] or Year 5 [0.00 (95% CI: 0.00–2.02)]. The overall pregnancy rate for the third, fourth and fifth years of product use was 0.63 per 100 WY; 95% CI: (0.17–1.62). Mean LNG concentrations remained well above 200 pg/mL (Year 3 = 280.9; Year 4 = 233.6; Year 5 = 270.6). Most participants (93.7%) described their bleeding pattern as acceptable.</p></div><div><h3>Conclusion</h3><p>Sino-implant (II) is a highly effective contraceptive method in this population of Chinese women over 5 years.</p></div><div><h3>Implications</h3><p>Sino-implant (II) is a highly effective contraceptive method with an estimated Pearl Index of less than 1% over the third, fourth and fifth years of use in a population of Chinese women of reproductive age.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"1 ","pages":"Article 100008"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2019.100008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38007175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive autonomy and contraceptive use among women in Hanoi, Vietnam","authors":"Nghia Nguyen ,&nbsp;Jessica Londeree ,&nbsp;Linh H Nguyen ,&nbsp;Dung H Tran ,&nbsp;Maria F. Gallo","doi":"10.1016/j.conx.2019.100011","DOIUrl":"10.1016/j.conx.2019.100011","url":null,"abstract":"<div><h3>Objective</h3><p>Reproductive autonomy (i.e., power to control and decide about contraceptive use, pregnancy and childbearing) could determine a woman’s capacity to use contraception. Although the Reproductive Autonomy Scale was developed to quantitatively assess women’s reproductive autonomy, it has not been validated in any population outside the United States.</p></div><div><h3>Study design</h3><p>We conducted a cross-sectional study of reproductive-age, sexually active women in Hanoi, Vietnam, who did not desire pregnancy. We administered a questionnaire containing the Reproductive Autonomy Scale and calculated composite scores of the measure’s three subscales: (1) decision-making power, (2) freedom from coercion and (3) communication ability. To assess internal consistency, we calculated Cronbach’s alpha score for each subscale. We used logistic regression to evaluate differences in subscale scores between women who did and did not engage in unprotected sex in the past month.</p></div><div><h3>Results</h3><p>Analysis is based on 500 participants; of these women, 17% (<em>n</em> <!-->=<!--> <!-->85) engaged in unprotected sex in the past month. Subscales had moderate to high internal consistency (Cronbach’s alpha: 0.65–0.87). Mean subscale scores did not vary between women who did and did not engage in recent unprotected sex. Unprotected sex in the past month was not associated with decision-making power (adjusted odds ratio [aOR], 0.77; 95% confidence interval [CI], 0.49–1.20), freedom from coercion (aOR, 0.94; 95% CI, 0.52–1.67) or communication ability (aOR, 1.69; 95% CI, 0.92–3.09).</p></div><div><h3>Conclusion</h3><p>Findings highlight the need to develop and validate a new measure for reproductive autonomy for populations outside the United States or to adapt the existing measure for these contexts.</p></div>","PeriodicalId":10655,"journal":{"name":"Contraception: X","volume":"1 ","pages":"Article 100011"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.conx.2019.100011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38007177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}