Contraception Use and Pregnancy Outcomes for Alabama Medicaid Enrollees: A Baseline Analysis Using 2012-2017 Data.
South Med J
; 115(12): 899-906, 2022 12.
Article
em En
| MEDLINE
| ID: mdl-36455898
ABSTRACT
OBJECTIVES:
Access to the full range of contraceptive methods, including long-acting reversible contraception (LARC), is key for preventing unintended pregnancies and improving health outcomes. In 2019, Alabama Medicaid started paying for LARC devices for postpartum women. In anticipation of evaluating the impact of this programmatic change, we conducted a baseline study exploring contraception use and pregnancy-end outcomes for enrollees before the change.METHODS:
A retrospective cohort of women enrolled in Alabama Medicaid from 2012 to 2017 was examined. Outcomes include pregnancy-end events for all enrollees, teen pregnancy-end events, and short-interval (SI) pregnancy-end events. Pregnancy events in year t are matched to contraception in year t - 1. Contraception is categorized as "no evidence," short-acting contraception (SAC), LARC, and sterilization. Bivariate and multivariate models were estimated.RESULTS:
Our final sample included 135,807 unique women who contributed 258,959 person-years. There was no evidence of contraception for 55.4% and evidence of SAC, LARC, and sterilization for 36.4%, 6.2%, and 2.0%, respectively. Relative risks for pregnancy-end events for SAC and LARC users were 0.63 (95% confidence interval [CI] 0.61-0.0.65) and 0.56 (95% CI 0.52-0.0.59), respectively, compared with women with no evidence of contraceptive use. For teen pregnancy-end events, relative risks for SAC and LARC users were 0.65 (95% CI 0.61-0.67) and 0.58 (95% CI 0.51-0.66), respectively. For SI pregnancy-end events, relative risks for SAC and LARC users were 0.71 (95% CI 0.68-0.76) and 0.40 (95% CI 0.34-0.46), respectively.CONCLUSIONS:
LARC and SAC are associated with lower likelihood of pregnancy-end events compared with no evidence of contraception, and on average, LARC is associated with lower relative risk than SAC, especially for SI pregnancy-end events.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Resultado da Gravidez
/
Medicaid
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Risk_factors_studies
Limite:
Adolescent
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Female
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Humans
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Pregnancy
País/Região como assunto:
America do norte
Idioma:
En
Revista:
South Med J
Ano de publicação:
2022
Tipo de documento:
Article
País de publicação:
EEUU
/
ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
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EUA
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UNITED STATES
/
UNITED STATES OF AMERICA
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US
/
USA