title: Contraceptive Use Among Women With Medical Conditions in a Nationwide Privately Insured Population.
abstract: OBJECTIVE
  To examine contraceptive use among women with selected medical conditions.
  
  
  METHODS
  We used a nationwide health care claims database to identify women aged 15-44 years continuously enrolled in private insurance during 2004-2011 with and without selected medical conditions. We assessed current permanent and reversible prescription contraceptive use during October 1, 2010, to September 30, 2011, with diagnosis, procedure, and pharmacy codes and calculated prevalence by age and condition. We used polytomous logistic regression to calculate odds of female sterilization or reversible prescription methods compared with neither. Among users of reversible methods, we used logistic regression to calculate odds of using long-acting reversible contraceptives compared with shorter acting methods.
  
  
  RESULTS
  A low proportion of women with medical conditions were using sterilization or reversible prescription methods (45% and 30% of women aged 15-34 and 35-44 years, respectively), and this proportion was consistently lower among the older age group across all medical conditions. Across both age groups, sterilization and long-acting reversible contraceptives were used less frequently than shorter acting methods (injectable, pill, patch, or ring). The odds of sterilization were higher among women with any compared with no condition for women aged 15-34 years (odds ratio [OR] 4.9, 95% confidence interval [CI], 4.5-5.3) and 35-44 years (OR 1.2, 95% CI, 1.1-1.2). Among women using reversible prescription methods, the odds of using long-acting reversible contraceptives were increased among those with any compared with no condition for women aged 15-34 years (OR 2.2, 95% CI, 2.1-2.5) and 35-44 years (OR 1.1, 95% CI, 1.1-1.2).
  
  
  CONCLUSIONS
  Despite the potential for serious maternal and fetal pregnancy-associated risks, contraceptive use was not optimal among women with medical conditions.
  
  
  METHODS
  III.
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Steven W
authors.initials: SW
authors.lastname: Champaloux
authors.forename: Naomi K
authors.initials: NK
authors.lastname: Tepper
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Curtis
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Zapata
authors.forename: Maura K
authors.initials: MK
authors.lastname: Whiteman
authors.forename: Polly A
authors.initials: PA
authors.lastname: Marchbanks
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007348:Insurance, Health; D016015:Logistic Models; D016017:Odds Ratio; D014481:United States; D055815:Young Adult