title: Evaluation of contraceptive methods in women with congenital heart disease in Germany, Hungary and Japan.
abstract: OBJECTIVE
  For women with congenital heart defects (CHD), pregnancy may pose a health risk. Sexually active women with CHD without the desire for own children or for whom pregnancy would imply considerable health risks require adequate counselling regarding appropriate contraception. This study gathers data on the contraceptive behaviour of women with CHD from three different cultural regions.
  
  
  RESULTS
  634 women with CHD from Germany, Hungary and Japan were surveyed regarding contraception and contraceptive methods (CM) used. The patients were divided into groups according to different criteria such as pregnancy associated cardiovascular risk or "safety" of the contraceptive methods used. 59% of the study participants had already gained experience with CM. The average age at the first time of use was 18.4 years; the German patients were significantly younger at the first time of using a CM than those from Hungary and Japan. Overall the condom was the method used the most (38%), followed by oral contraceptives (30%) and coitus interruptus (11%). The range of CM used in Japan was much smaller than that in Germany or Hungary. Unsafe contraceptives were currently, or had previously been used, by 29% of the surveyed patients (Germany: 25%, Hungary: 37%, Japan: 32%).
  
  
  CONCLUSIONS
  Most women with CHD use CM. There are differences between the participating countries. Adequate contraceptive counselling of women with CHD requires considering the individual characteristics of each patient, including potential contraindications. For choosing an appropriate CM, both the methods' "safety", as well as the maternal cardiovascular risk, are important.
authors.affiliation: German Heart Centre Munich, Department of Paediatric Cardiology and Congenital Heart Defects, Technical University of Munich, Germany; Competence Network for Congenital Heart Defects, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Germany. Electronic address: niggemeyer@kompetenznetz-ahf.de.
authors.forename: M-A
authors.initials: MA
authors.lastname: Koerten
authors.affiliation: Gottsegen Hungarian Institute of Cardiology, Pediatric Cardiac Centre, Budapest, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Szatmári
authors.affiliation: St. Luke's International Hospital, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Niwa
authors.affiliation: University of Szeged, Medical Faculty, 2nd Department of Medicine and Cardiology Center, Division of Invasive Cardiology, Szeged, Hungary.
authors.forename: Z
authors.initials: Z
authors.lastname: Ruzsa
authors.affiliation: German Heart Centre Munich, Department of Paediatric Cardiology and Congenital Heart Defects, Technical University of Munich, Germany; German Heart Institute Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Nagdyman
authors.affiliation: Competence Network for Congenital Heart Defects, Berlin, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Niggemeyer
authors.affiliation: Otto-von-Guericke University of Magdeburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Peters
authors.affiliation: Frauenklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: K T M
authors.initials: KT
authors.lastname: Schneider
authors.affiliation: Frauenklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Kuschel
authors.affiliation: Chiba Cardiovascular Center, Department of Adult Congenital Heart Disease and Pediatrics, Ichihara, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Mizuno
authors.affiliation: German Heart Institute Berlin, Department of Congenital Heart Disease and Pediatric Cardiology, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Berger
authors.affiliation: Competence Network for Congenital Heart Defects, Berlin, Germany. Electronic address: ubauer@kompetenznetz-ahf.de.
authors.forename: U M M
authors.initials: UM
authors.lastname: Bauer
authors.affiliation: German Heart Centre Munich, Department of Paediatric Cardiology and Congenital Heart Defects, Technical University of Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Kaemmerer
mesh_terms: D000328:Adult; D003267:Contraception / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data; D003273:Contraceptive Devices / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006330:Heart Defects, Congenital / Q000503:physiopathology*; D006801:Humans; D006814:Hungary; D007564:Japan; D010353:Patient Education as Topic; D012307:Risk Factors; D055815:Young Adult
keywords: Congenital heart disease; Contraception; Multicentre study; Pregnancy associated cardiovascular risk; Women