There is an unmet need for safe and accessible contraceptive options among hypertensive individuals at risk of unintended pregnancy, according to a recent study published in the American Journal of Obstetrics & Gynecology.
Takeaways
- Hypertension affects a significant portion of the US population and is linked to adverse pregnancy outcomes, emphasizing the importance of addressing contraceptive needs in this group.
- Black individuals face a disproportionate burden of adverse outcomes related to hypertension, highlighting the necessity for targeted interventions and support.
- Current data on contraceptive counseling and provision among hypertensive individuals is lacking, underscoring the need for further research and awareness.
- Contraceptive counseling rates are higher among hypertensive individuals compared to those without hypertension, suggesting some awareness of the importance of contraception in this population.
- Disparities exist in contraceptive counseling and use among hypertensive individuals, especially among Black patients, indicating a need for more equitable access to contraception and tailored health care services.
Approximately 86 million US adults are impacted by hypertension, making it the most common modifiable risk factor for cardiovascular disease. Hypertension has been linked to poor fetal and maternal outcomes, such as eclampsia, preeclampsia, placental abruption, preterm birth, and fetal growth restriction.
Black patients are disproportionally impacted by adverse outcomes, with the maternal mortality rate among this population increased 2.9-fold compared to non-Hispanic White patients. A hypertensive disorder was reported in 1/3 of deaths during delivery hospitalizations in 2020.
Data about contraception counseling and provision among individuals with hypertension is currently lacking.To evaluate contraceptive counseling and use among patients with hypertension, investigators conducted a retrospective cross-sectional analysis.
The National Survey of Family Growth (NSFG) 2015 to 2017 and 2017 to 2019 cycles were assessed for data. NSFG respondents were aged 15 to 49 years and were stratified using a multistage, probability-based process.
Participants responded to a question asking, “In the last 12 months, did a doctor or other medical care provider tell you that you had hypertension, also called high blood pressure?” Those who replied with “yes” were included in the hypertension group while those who responded “no” were included in the no-hypertension group.
Contraceptive counseling and contraception use were the primary outcomes of the analysis. Data on these factors was obtained from a question asking participants if they received birth control counseling in the prior 12 months and whether they received a birth control method in the prior 12 months.
Cofounders included race, age, educational attainment, parity, smoking, diabetes, body mass index, and social determinants of health (SDH). Age groups included under 35 years and 35 years or older. SDH domains included food insecurity, housing instability, financial insecurity, transportation barriers, and unmet childcare needs.
