Saturday, December 26, 2015

Unintended Pregnancy Risk & Contraceptive Use among Women Aged 45 to 50 Years - Massachusetts, 2006, 2008, and 2010

BACKGROUND:
Little is known about unintended pregnancy (UIP) risk and current contraceptive use among women aged 45 years and over in the United States (US).

OBJECTIVES:
To describe the prevalence of women aged 45-50 years at risk for UIP and their current contraceptive use and to compare these findings to those of women in younger age groups.

STUDY DESIGN:
We analyzed 2006, 2008 and 2010 Massachusetts Behavioral Risk Factor Surveillance System data, the only US state to routinely collect contraceptive data from women beyond age 44 years. Women aged 18-50 years (n=4,930) were considered at risk for UIP unless they reported current pregnancy, past hysterectomy, not being sexually active in the past year, having a same sex partner, or wanting to become pregnant. Among women considered at risk (n=3,605), we estimated the prevalence of current contraceptive use by age group. Among women considered at risk and aged 45-50 years (n=940), we examined characteristics associated with current method use. Analyses were conducted on weighted data using SUDAAN.

RESULTS:
Among women aged 45-50 years, 77.6% were at risk for UIP, which was similar to other age groups. As age increased, hormonal contraceptive use (shots, pills, patch, or ring) decreased, while permanent contraception (tubal ligation or vasectomy) increased as did non-use of contraception. Of women aged 45-50 years at risk for UIP, 66.9% reported using some contraceptive method; permanent contraception was the leading method reported by 44.0% and contraceptive non-use was reported by 16.8%.

CONCLUSION:
A substantial proportion of women aged 45-50 years were considered at risk for UIP. Permanent contraception was most commonly used by women in this age group. Compared with other age groups, more women aged 45-50 years were not using any contraception. Population-based surveillance efforts are needed to follow trends among this age group and better meet their family planning needs. Although expanding surveillance systems to include women through age 50 years requires additional resources, fertility trends showing increasingly delayed childbearing, uncertain end of fecundity, and potential adverse consequences of unplanned pregnancy in older age may justify these expenditures.

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  • 1Department of Family Medicine, University of Washington, Box 354696, Seattle, WA 98105 USA; Division of Reproductive Health, Centers for Disease Control and Prevention, NCCDPHP/DRH/WHFB, 4770 Buford Hwy, NE, MS F-74, Atlanta GA 30341 USA. Electronic address: godfreye@uw.edu.
  • 2Division of Reproductive Health, Centers for Disease Control and Prevention, NCCDPHP/DRH/WHFB, 4770 Buford Hwy, NE, MS F-74, Atlanta GA 30341 USA.
  • 3Department of Public Health, St. Catherine University, 2004 Randolph Avenue, St. Paul, MN 55105. 


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