Family-Planning Practices Among Women With Diabetes and Overweight and Obese Women in the 2002 National Survey for Family Growth
- Anjel Vahratian, PHD, MPH1,
- Jennifer S. Barber, PHD2,
- Jean M. Lawrence, SCD, MPH, MSSA3 and
- Catherine Kim, MD, MPH4
- 1Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan;
- 2Department of Sociology and the Institute for Social Research, University of Michigan, Ann Arbor, Michigan;
- 3Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California;
- 4Department of Medicine and the Department Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
- Corresponding author: Anjel Vahratian, amv{at}med.umich.edu.
Abstract
OBJECTIVE To examine contraceptive practices among diabetic women and obese women.
RESEARCH DESIGN AND METHODS We analyzed the responses of 5,955 participants aged 20–44 years in the 2002 National Survey for Family Growth. Diabetes, BMI, desire for pregnancy, history of infertility treatment, sexual activity, parity, and demographic variables (age, race/ethnicity, education, marital status, income, insurance, and smoking history) were obtained by self-report. Lack of contraception was defined as absence of hormonal-, barrier-, or sterilization-based methods. Associations among contraception, diabetes, and BMI category were assessed in multivariable logistic regression models in nonsterile, sexually active women.
RESULTS In unadjusted comparisons among sexually active women who were not sterilized, women with diabetes were more likely to lack contraception than women without diabetes (odds ratio [OR] 2.61 [95% CI 1.22–5.58]). Women with BMI ≥35 kg/m2 were more likely to lack contraception than women with BMI <25 kg/m2(1.63 [1.16–2.28]), but associations between contraception use and lesser degrees of overweight and obesity were not significant. In multivariable models, women who were older (aged ≥30 vs. 20–29 years), were of non-Hispanic black race, were cohabitating, had a history of infertility treatment, and desired or were ambivalent about pregnancy were significantly more likely to lack contraception. The associations among diabetes, BMI, and contraception were no longer significant after these adjustments.
CONCLUSIONS Older women with diabetes and obesity who desire pregnancy, regardless of pregnancy intention, should be targeted for preconceptive management.
Footnotes
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The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the funding agency.
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received November 24, 2008.
- Accepted February 14, 2009.
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Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
- © 2009 by the American Diabetes Association.
