Hypertension and contraceptive use among women of child-bearing age in the United States from 2001 to 2018.

Autor:	Kovell LC; Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School.; Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester., Meyerovitz CV; University of Massachusetts Chan Medical School., Skaritanov E; University of Massachusetts Chan Medical School., Ayturk D; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School., Person SD; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School., Kumaraswami T; Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester., Juraschek SP; Division of General Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston., Moore Simas TA; Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester.; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School.; Departments of Pediatrics and Psychiatry, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Journal of hypertension [J Hypertens] 2022 Apr 01; Vol. 40 (4), pp. 776-784.
DOI:	10.1097/HJH.0000000000003077
Abstrakt:	Background: Hypertension (HTN) in pregnancy is a leading cause of maternal mortality in the United States. Contraception is widely used, and estrogen-based combined hormonal forms are known to increase blood pressure (BP). With nearly half of pregnancies unplanned and many antihypertensive medications teratogenic, appropriate contraception is critical in child-bearing age women with HTN. Methods: Using the National Health and Nutrition Examination Surveys (NHANES) from 2001 to 2018, we evaluated contraception and antihypertensive medication use in women of child-bearing age (20-50 years). Women who had undergone sterilization or menopause were excluded. HTN was defined based on a self-reported provider diagnosis and BP ≥130/80 mm Hg or antihypertensive medication use. Contraception included non-barrier methods (pills/patch/ring, injections, long-acting reversible contraceptives) or consistent condom use. Multivariable logistic regression was used to model the odds of contraception use. Temporal trends in contraception use were reported. Results: Of the 8726 women, 12.4% had HTN with mean age (standard error) 36.0 (0.3) years. In women with HTN, 9.2% used non-barrier contraception and 10.4% used condoms only. Over half (52.7%) of women with HTN on antihypertensive medications were taking medications contraindicated in pregnancy, with no difference seen by contraceptive status. In logistic regression models, contraceptive use was lower in the older-aged women. In women with HTN on non-barrier contraception, combined hormonal contraceptive use declined, from 100% (2001-2006) to 81.4% (2013-2018, P < 0.001). Conclusions: Many women with self-reported HTN are not using adequate contraception. Of the small proportion on non-barrier contraceptives, the majority are using estrogen-based, BP-raising methods. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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