Highly Effective Postpartum Contraceptive Use among Urban Thai Women with and without Gestational Diabetes Mellitus: A Comparative Cross-Sectional Study
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Abstract
Objectives: Gestational diabetes mellitus (GDM) is associated with increased risks in subsequent pregnancies, making effective postpartum contraception essential. This study compared the use of highly effective contraceptive methods at 6 weeks postpartum in urban Thai women with and without GDM. The use of other contraceptive methods in both groups was also examined.
Materials and Methods: This comparative cross-sectional study was conducted at a tertiary care hospital in Bangkok, Thailand. Postpartum women attending routine 6-week follow-up visits between February 5, 2021, and July 7, 2021, were enrolled. Women with recent GDM were compared with women without GDM. The primary outcome was the proportion of women using highly effective contraception (female or male sterilization, or long-acting reversible contraception) at 6 weeks postpartum. Secondary outcomes included the use of non-highly effective contraceptive methods. Multivariable logistic regression evaluated associations between GDM status and contraceptive choice while adjusting for potential confounders.
Results: A total of 156 women were included (78 with GDM and 78 without GDM). The use of highly effective contraceptive methods did not differ significantly between the GDM and non-GDM groups (44.9% vs. 32.1%, p = 0.100). However, female sterilization was more frequently selected by women with GDM than by women without GDM (39.8% vs. 18%, p = 0.003). The use of non–highly effective contraceptive methods tended to be lower in the GDM group, although the difference did not reach statistical significance (39.8% vs. 55.1%, p = 0.054). After adjustment, GDM was independently associated with female sterilization selection (adjusted odds ratio, 1.96; 95% confidence interval, 1.03–4.72).
Conclusion: The overall use of highly effective contraception at 6 weeks postpartum did not differ significantly between urban Thai women with and without GDM. However, women with GDM more frequently selected female sterilization. The use of non-highly effective contraceptive methods was similar between the two groups.
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