Contraceptive use by diabetic and obese women

Chuang, Cynthia H.; Chase, Gary A.; Bensyl, Diana M.; Weisman, Carol S.

doi:10.1016/j.whi.2005.04.002

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Volume 15, Issue 4 , Pages 167-173, July 2005

Contraceptive use by diabetic and obese women

Cynthia H. Chuang, MD, MSc
- Division of General Internal Medicine, Department of Medicine, Department of Health Evaluation Sciences, Pennsylvania State College of Medicine, Hershey, Pennsylvania
- Correspondence to: Cynthia H. Chuang, MD, MSc, Division of General Internal Medicine, Department of Medicine, Department of Health Evaluation Sciences, Pennsylvania State College of Medicine, Mail Code HU15, 500 University Drive, P.O. Box 850, Hershey, PA 17033-0850.
Gary A. Chase, PhD
- Department of Health Evaluation Sciences, Pennsylvania State College of Medicine, Hershey, Pennsylvania
Diana M. Bensyl, PhD
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia
Carol S. Weisman, PhD
- Department of Health Evaluation Sciences and Obstetrics and Gynecology, Pennsylvania State College of Medicine, Hershey, Pennsylvania

Received 3 January 2005; received in revised form 22 April 2005; accepted 4 May 2005.

Purpose

Women with chronic medical conditions are at increased risk for adverse pregnancy outcomes, yet contraceptive use by these women has not been well described. The purpose of this study was to describe contraceptive use by diabetic and overweight/obese women compared with women without these conditions.

Methods

Using cross-sectional data from the 11 states participating in the optional Family Planning Module of the Behavioral Risk Factor Surveillance System in 2000, we analyzed contraceptive use among 7,943 sexually active women of reproductive age (18–44) who were not trying to conceive. Using logistic regression techniques, we modeled the effect of diabetes and overweight/obesity on contraceptive nonuse, controlling for age, race/ethnicity, marital status, education, income, and health insurance coverage.

Main Findings

Contraceptive nonuse was reported by 1,500 (18.9%) of the total sample, 31 (25.8%) diabetic women, 371 (20.0%) overweight women, and 385 (23.4%) obese women. In the multivariable model, obesity was significantly associated with contraceptive nonuse (adjusted odds ratio [OR] 1.34, 95% confidence interval [CI] 1.16–1.55), but there were no significant differences in contraceptive nonuse for diabetic women (adjusted OR 1.23, 95% CI 0.80–1.87) or overweight women (adjusted OR 1.14, 95% CI 0.99–1.31). Older, Black, Hispanic, married, less educated, and women without health insurance were more likely to report contraceptive nonuse.

Conclusion

Among women with need for contraception, obese women were more likely to report contraceptive nonuse than normal weight women. Because women with chronic conditions like obesity are at higher risk of pregnancy-related complications and adverse pregnancy outcomes, proper contraceptive use and unintended pregnancy avoidance is a priority.

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