Family-planning practices among women with diabetes and overweight and obese women in the 2002 National Survey For Family Growth.
OBJECTIVE
To examine contraceptive practices among diabetic women and obese women.


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 >or=35 kg/m(2) were more likely to lack contraception than women with BMI <25 kg/m(2)(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 >or=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.
Vahratian
Anjel
A
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA. Anjel Vahratian, amv@med.umich.edu
Barber
Jennifer S
JS
Lawrence
Jean M
JM
Kim
Catherine
C
D000293:Adolescent; D000328:Adult; D003920:Diabetes Mellitus / Q000503:physiopathology* / Q000523:psychology; D004522:Educational Status; D005006:Ethnicity; D005191:Family Characteristics; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D050177:Overweight / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011336:Probability; D044469:Racial Groups; D012725:Sexual Behavior; D014481:United States / Q000453:epidemiology; D055815:Young Adult