Contraception最新文献

{"title":"Copyright info/Contents","authors":"","doi":"10.1016/S0010-7824(25)00116-7","DOIUrl":"10.1016/S0010-7824(25)00116-7","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110925"},"PeriodicalIF":2.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copyright info/Contents","authors":"","doi":"10.1016/S0010-7824(25)00073-3","DOIUrl":"10.1016/S0010-7824(25)00073-3","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110882"},"PeriodicalIF":2.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tribute to Prof. Eberhard Nieschlag","authors":"Regine Sitruk-Ware","doi":"10.1016/j.contraception.2025.110868","DOIUrl":"10.1016/j.contraception.2025.110868","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"145 ","pages":"Article 110868"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary surgical planning for a patient with hyperthyroidism complicating a twin gestation of a complete hydatidiform mole and a coexisting fetus","authors":"Gillian Piltch ,&nbsp;Charit Taneja ,&nbsp;Justin Feit ,&nbsp;Elizabeth O. Schmidt","doi":"10.1016/j.contraception.2025.110866","DOIUrl":"10.1016/j.contraception.2025.110866","url":null,"abstract":"<div><div>This case report demonstrates hyperthyroidism complicating a twin gestation consisting of a complete hydatidiform mole and coexisting fetus. The patient underwent medical optimization of hyperthyroidism with a thionamide and beta blocker prior to undergoing uncomplicated dilation and evacuation under spinal anesthesia. She was cared for by a multidisciplinary team.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110866"},"PeriodicalIF":2.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of denying abortion access to patients with chronic kidney disease: A cost-effectiveness analysis","authors":"Sydney McCarthy,&nbsp;Julia Tasset,&nbsp;Olivia Curl,&nbsp;Sarah Dzubay,&nbsp;Aaron B. Caughey","doi":"10.1016/j.contraception.2025.110863","DOIUrl":"10.1016/j.contraception.2025.110863","url":null,"abstract":"<div><h3>Objectives</h3><div>The current study focuses on how abortion access affects people who are pregnant, have chronic kidney disease (CKD), and desire an abortion. From the perspective of the pregnant patient, we will examine the outcomes and costs associated with providing or refusing in-state access to abortion for this population.</div></div><div><h3>Study design</h3><div>A decision-analytic model was built to compare the outcomes and costs associated with providing abortions in-state compared to those associated with a complete statewide abortion ban. The model includes outcomes of pregnancy with CKD and considers the progression of disease. The model also considers the likelihood and costs associated with traveling to another state for an abortion.</div></div><div><h3>Results</h3><div>In a cohort of 31,243 pregnant people with CKD desiring an abortion, providing abortions resulted in 1350 fewer cases of preeclampsia, 2703 fewer preterm births, 4837 fewer cases of CKD stage progression, 841 fewer cases of end-stage renal disease requiring dialysis, and nine fewer deaths per year. An absence of in-state abortion access was associated with an increased cost of $533,874,448 and a decrease of 6873 quality adjusted life years (QALYs) compared to states with abortion access.</div></div><div><h3>Conclusion</h3><div>Providing in-state abortion access to pregnant people with chronic kidney disease is a cost-effective strategy, due to the direct decrease in preeclampsia, preterm birth, mortality, and progression of kidney disease.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110863"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copyright info/Contents","authors":"","doi":"10.1016/S0010-7824(25)00036-8","DOIUrl":"10.1016/S0010-7824(25)00036-8","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"144 ","pages":"Article 110845"},"PeriodicalIF":2.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143547841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uses of ulipristal acetate beyond emergency contraception: A narrative review","authors":"Ashley M. Ebersole ,&nbsp;Abigail Liberty ,&nbsp;Alison Edelman ,&nbsp;Elizabeth Lyman ,&nbsp;Kelly Cleland","doi":"10.1016/j.contraception.2025.110862","DOIUrl":"10.1016/j.contraception.2025.110862","url":null,"abstract":"<div><h3>Objectives</h3><div>Ulipristal acetate (UPA) is a selective progesterone receptor modulator and the most effective oral emergency contraceptive (EC) method available in the United States. The aim of this review is to identify and describe uses of UPA beyond EC and to further discuss the concerns regarding the possible off-target liver effects.</div></div><div><h3>Study design</h3><div>We conducted a literature search in August 2024, using Embase, Medline (PubMed), and Cochrane, utilizing a combination of MeSH and keywords for UPA, excluding animal studies, and limiting to English language publications. After excluding duplicates using covidence, two authors reviewed the remaining 610 results and identified 340 studies. We further excluded case reports and case series.</div></div><div><h3>Results</h3><div>UPA has shown significant promise for indications outside of EC, most notably treatment of uterine leiomyomas, but also ongoing contraception, prevention and treatment of breast cancer, and abnormal uterine bleeding. While UPA has extensive potential for use both within and beyond reproductive health, unfortunately any ongoing development is at a standstill due to concerns regarding its possible role in causing serious liver injury. The role of UPA in causing drug-induced liver injury is not confirmed and preclinical studies during development did not demonstrate a concern that UPA causes drug-induced liver injury.</div></div><div><h3>Conclusions</h3><div>Access to UPA is crucial not only for EC but for the treatment of many other gynecological and nongynecological conditions.</div></div><div><h3>Implications</h3><div>Ulipristal acetate (UPA) has shown significant promise for indications outside of EC, including uterine leiomyomas, prevention and treatment of breast cancer, and abnormal uterine bleeding. Access to UPA is crucial not only for EC but for the treatment of many other gynecologic and non-gynecologic conditions.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110862"},"PeriodicalIF":2.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estetrol/Drospirenone safety in a population with cardiovascular risk factors","authors":"Mitchell D. Creinin ,&nbsp;Jean Michel Foidart ,&nbsp;Kristina Gemzell-Danielsson ,&nbsp;Nina C. Flerin ,&nbsp;Ali Kubba ,&nbsp;Ulysse Gaspard ,&nbsp;Jonathan Douxfils","doi":"10.1016/j.contraception.2025.110861","DOIUrl":"10.1016/j.contraception.2025.110861","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate cardiovascular safety outcomes in estetrol 15 mg/drospirenone 3 mg users with cardiovascular risk factors.</div></div><div><h3>Study design</h3><div>We performed a secondary analysis of two open-label contraceptive phase-3 trials that enrolled participants 16 to 50 years to use estetrol/drospirenone for up to 13 cycles. Study exclusion criteria included &gt;35 years and smoking, body mass index &gt;35 kg/m², and baseline blood pressure (BP) &gt;140/90 mmHg. We compared adverse event rates in participants with and without cardiovascular risk factors and assessed discontinuation rates for cardiovascular adverse events.</div></div><div><h3>Results</h3><div>Of 3417 participants, 1410 (41.3%) had one or more, and 309 (9.0%) had two or more cardiovascular risk factors. We found no difference in discontinuation for any adverse events in participants with and without cardiovascular risk factors. Six (0.18%) participants discontinued for a cardiovascular complaint including four with risk factors: three (0.09%) due to hypertension (all had baseline BP ≥130/85 mmHg and one or more additional risk factors) and one due to venous thrombosis (BP ≥130/85 mmHg). Of 375 participants with baseline BP ≥130/85 mmHg, 0.8% (95% CI 0%–1.7%) discontinued for hypertension while among the 192 participants with baseline BP ≥130/85 mmHg and one or more additional cardiovascular risk factors, 1.6% (95% CI 0%–3.3%) discontinued for hypertension.</div></div><div><h3>Conclusions</h3><div>Among &gt;1400 study participants with cardiovascular risk factors using estetrol/drospirenone, only three (0.2%) discontinued for hypertension, all of whom had high-normal baseline BP and at least one other risk cardiovascular risk factor.</div></div><div><h3><strong>Implications</strong></h3><div>Estetrol/drospirenone use demonstrates excellent cardiovascular tolerance in study participants with normal and high-normal blood pressure, even in those with cardiovascular risk factors. The very low rate of hypertension, even when cardiovascular risk factors were present, provides evidence to warrant clinical trials of estetrol/drospirenone in patients with hypertension desiring contraception.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110861"},"PeriodicalIF":2.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with severe pain during medication abortion at ≤9 weeks’ gestation: A secondary analysis of a multicenter, randomized, placebo-controlled trial","authors":"Kelsey B. Loeliger ,&nbsp;Monica V. Dragoman ,&nbsp;Nathalie Kapp ,&nbsp;Anand Tamang ,&nbsp;Tshegofatso Bessenaar ,&nbsp;Duong Lan Dung ,&nbsp;Jageshwor Gautam ,&nbsp;Jean-Louis Yoko ,&nbsp;Nguyen Hong Minh ,&nbsp;Daniel Grossman","doi":"10.1016/j.contraception.2025.110859","DOIUrl":"10.1016/j.contraception.2025.110859","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to identify covariates other than pain management regimen associated with severe pain during medication abortion at ≤9 weeks’ gestation.</div></div><div><h3>Study design</h3><div>This is a secondary analysis of a randomized trial in Vietnam, Nepal, and South Africa investigating two prophylactic pain management regimens during medication abortion. We used multivariable logistic regression models to identify factors associated with severe pain within 8 hours after taking misoprostol.</div></div><div><h3>Results</h3><div>During June 2016 to October 2017, 273 of 556 (49.1%) participants experienced severe pain (score ≥8 out of 10). In multivariable analyses, controlling for study center and prophylactic treatment arm, multiparity (odds ratio [OR] 0.35, 95% CI 0.23–0.53) was associated with reduced odds of severe pain, while dysmenorrhea (OR 1.16, 95% CI 1.07–1.26) and higher gestational duration (OR 1.05, 95% CI 1.01–1.09) were associated with increased odds of pain. Higher anticipated pain score (OR 1.10, 95% CI 0.99–1.23) was marginally associated with severe pain. Among multiparous patients, history of cesarean delivery (OR 3.49, 95% CI 1.24–9.77), severe pain in childbirth (OR 2.36, 95% CI 1.03–5.42), and dysmenorrhea (OR 1.22, 95% CI 1.08–1.39) were significantly associated with severe pain. Higher gestational duration (OR 1.05, 95% CI 0.99–1.11) trended toward an association with severe pain. Sociodemographic variables, including younger age, marital status, financial stability, and anxiety or depression, were not associated with pain.</div></div><div><h3>Conclusions</h3><div>Beyond known risk factors of nulliparity, dysmenorrhea, and gestational duration, this analysis demonstrates that severe pain during medication abortion is significantly associated with history of cesarean delivery and severe pain in childbirth. Depression and anxiety were not associated with severe pain. These findings can inform counseling for patients seeking medication abortion.</div></div><div><h3>Implications</h3><div>Education and counseling prior to medication abortion should include information about the range of factors associated with increased pain. This information can help individuals make informed decisions about their abortion method and, for those choosing medication abortion, better prepare for and optimize their pain management.</div></div><div><h3>Clinical Trial Registration Number</h3><div>ACTRN126130 0 0 017729</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110859"},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pennsylvania Medicaid policy and rural hospital implementation of immediate postpartum contraception","authors":"Sarah Horvath ,&nbsp;Emma G. Guare ,&nbsp;Grace Ferguson ,&nbsp;Cynthia H. Chuang","doi":"10.1016/j.contraception.2025.110858","DOIUrl":"10.1016/j.contraception.2025.110858","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess the importance of Pennsylvania Medicaid immediate postpartum long-acting reversible contraception (IPLARC) reimbursement policy changes for hospital implementation of IPLARC by rurality.</div></div><div><h3>Study design</h3><div>We surveyed clinician leaders at 51 of 82 (62.2%) Pennsylvania hospitals with labor and delivery units in 2022, including 10 of 51 (19.6%) rural and 17 of 51 (33.3%) academic.</div></div><div><h3>Results</h3><div>Six years after Pennsylvania Medicaid began covering IPLARC outside the obstetrical care bundle, only 3 of 10 (30.0%) rural and 18 of 41 (43.9%) nonrural labor and delivery units had implemented IPLARC.</div></div><div><h3>Conclusions</h3><div>Fewer than half of delivering hospitals in Pennsylvania offered access to IPLARC, even after favorable Medicaid reimbursement policy changes. Nonrural hospitals are more likely to offer IPLARC than rural hospitals.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"146 ","pages":"Article 110858"},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}