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Am J Perinatol 2019; 36(12): 1310-1316
DOI: 10.1055/s-0038-1676831
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Antepartum Contraceptive Counseling in Women with Preterm Birth

Marika Toscano
1   Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York
,
Dongmei Li
1   Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York
,
Timothy Dye
1   Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York
,
Courtney Olson-Chen
1   Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York
› Author Affiliations
Further Information

Publication History

28 June 2018

19 November 2018

Publication Date:
04 January 2019 (online)

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Abstract

Objective To compare rates of antepartum contraceptive counseling among women with preterm birth (PTB) and term birth.

Study Design This is a retrospective cohort study of patients with completed delivery records in New York from January 1, 2004, to December 31, 2014. Exposure was determined based on the timing of delivery. Exposed women delivered at <37 weeks, and nonexposed women delivered at ≥37 weeks. Primary outcome was patient response to questions regarding receipt of prenatal contraceptive counseling (PCC) by a health care provider. Secondary outcome was receipt of interpregnancy interval counseling. Chi-square tests and multivariate logistic regression were used for analysis.

Results Of 724,723 delivery records, PTB rate was 7.9%. Women with PTB < 37 weeks were significantly less likely to receive PCC (odds ratio [OR]: 0.9; 95% confidence interval [CI]: 0.89–0.93) or interpregnancy interval counseling (OR: 0.95; 95% CI: 0.94–0.97). The primary outcome remained significant after adjusting for confounders (adjusted OR: 0.91; 95% CI: 0.89–0.93). PTB < 34 weeks was associated with even lower odds of receiving contraceptive counseling (OR: 0.79; 95% CI: 0.76–0.83).

Conclusion Postpartum contraception is an important tool for the prevention of recurrent PTB. Antepartum contraception counseling increases postpartum contraceptive uptake. Women with PTB have less exposure to antepartum contraceptive counseling. Lack of adequate counseling and decreased uptake of postpartum contraception may impact future pregnancy outcomes.

Keywords

preterm birth - antepartum contraceptive counseling - interpregnancy interval