Mental health diagnoses and early removal of long-acting reversible contraception.

Abstract:

BACKGROUND:Having a mental health diagnosis is associated with contraceptive non-adherence and user-related contraceptive failures of short-acting methods. There is a lack of research on the relationship between mental health diagnoses and early discontinuation of highly effective long-acting reversible (LARC) methods such as the intrauterine device (IUD) and subdermal implant (SDI). METHODS:Using a Primary Care and Obstetrics and Gynecology Patient Data Registry, we conducted a cross-sectional analysis of the relationship between any mental health diagnosis (any anxiety disorder or depression) and early LARC removal (<1 year post-insertion) among 385 reproductive-aged (14-50 years) women in 2008-16. Adjusted logistic regression was used to calculate odds ratios and 95% confidence intervals. RESULTS:Almost 10% (n = 37) of the sample had an early LARC removal, of which 62.2% were hormonal IUD and 37.8% were SDI. Women with a mental health diagnosis had a higher prevalence of early LARC removal (13.6% vs. 8.0%, p = =.090). Although non-significant, there was a trend in adjusted analyses indicating twice the odds of early removal for women with a mental health diagnosis versus no diagnosis (OR = =2.04, 95% CI = =0.97-4.27). LIMITATIONS:This study is limited by a small sample size and availability of variables from a reportable medical record database. Pregnancy intentions and side effects of method use could not be accounted for which may have impacted timing of removal. CONCLUSIONS:Understanding why women choose early LARC removal can inform counseling to help women make informed choices about their contraceptive method that meets their reproductive needs.

journal_name

J Affect Disord

authors

Bello JK,Salas J,Meyer D,Heiden-Rootes K,Davis DM,Keegan Garrett E,White MM,Schmeidler P

doi

10.1016/j.jad.2019.11.046

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

333-336

eissn

0165-0327

issn

1573-2517

pii

S0165-0327(19)31473-9

journal_volume

262

pub_type

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