title: Provision of family planning to women with cardiovascular risk factors.
abstract: BACKGROUND
  Cardiovascular risk factors (CVRFs) in reproductive-aged women can lead to pregnancy complications and fetal anomalies.
  
  
  METHODS
  We performed a cross-sectional analysis using data from the National Ambulatory Medical Care Survey, 2009-2010. The study sample included visits by reproductive-aged women with CVRFs diabetes, hypertension, hyperlipidemia, obesity, or tobacco use. The comparison group was visits by reproductive-aged women with no chronic disease. Family planning action was defined as counseling, medication, or procedure.
  
  
  RESULTS
  Among an estimated 223,407,070 ambulatory visits, 30.8% were associated with at least 1 CVRF, and 17.2% had at least 1 family planning action. There was no increased frequency of family planning for visits by women with CVRFs compared with those with no chronic disease (17.4% vs 17.1%, respectively). In the multivariable model, the odds ratio (OR) of a woman with a CVRF receiving family planning was 1.2 (95% confidence interval [CI], 0.9-1.5). Visits for preventive care (OR, 2.3; 95% CI, 1.8-3.1), as well as gynecologic and sexual health care (OR, 2.6; 95% CI, 1.9-3.7), were significantly associated with increased odds of family planning.
  
  
  CONCLUSIONS
  There are low rates of family planning during visits by reproductive-aged women overall, with no significant difference for visits by women with CVRFs. Comprehensive preventive visits in primary care may especially benefit women of reproductive age with CVRFs, reducing the risk of poor pregnancy outcomes.
authors.affiliation: From Boston University School of Medicine Department of Medicine (SMR, AR) and School of Public Health Department of Biostatistics (HC) and Department of Health Policy and Management (HC, LK), Boston, MA. reddy.shivani@gmail.com.
authors.forename: Shivani M
authors.initials: SM
authors.lastname: Reddy
authors.affiliation: From Boston University School of Medicine Department of Medicine (SMR, AR) and School of Public Health Department of Biostatistics (HC) and Department of Health Policy and Management (HC, LK), Boston, MA.
authors.forename: Ambili
authors.initials: A
authors.lastname: Ramachandran
authors.affiliation: From Boston University School of Medicine Department of Medicine (SMR, AR) and School of Public Health Department of Biostatistics (HC) and Department of Health Policy and Management (HC, LK), Boston, MA.
authors.forename: Howard
authors.initials: H
authors.lastname: Cabral
authors.affiliation: From Boston University School of Medicine Department of Medicine (SMR, AR) and School of Public Health Department of Biostatistics (HC) and Department of Health Policy and Management (HC, LK), Boston, MA.
authors.forename: Lewis
authors.initials: L
authors.lastname: Kazis
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases; D003430:Cross-Sectional Studies; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015233:Models, Statistical; D012307:Risk Factors; D055815:Young Adult
keywords: Cardiovascular Pregnancy Complications; Preconception Care; Prevention and Control