Journal of pediatric and adolescent gynecology · 2025
Comparison of Long-Acting Reversible Contraceptive (LARC) Choices by Multiethnic U.S. Adolescents and Young Adults With and Without Eating Disorders: A Multicenter Cohort Study.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Ferrigno-Layton Nicole R, Milliren Carly E, Pitts Sarah, DiVasta Amy D, Escovedo Michelle, Golub Sarah A, Coupey Susan M, Maslyanskaya Sofya
Аннотация
STUDY OBJECTIVE: Body image concerns may influence contraceptive choices of adolescents and young adults (AYAs) with eating disorders (EDOs). We aimed to compare long-acting reversible contraceptive (LARC) choices and continuation rates for AYAs with and without EDOs.
METHODS: We used data on LARC insertions from 2017 to 2021 from four US adolescent medicine practices measuring demographics, menstrual history, reason for LARC device, follow-up, and continuation. Additional record search identified participants with EDOs. We examined associations of EDOs and choice of device using adjusted logistic regression and 1-year discontinuation using Cox proportional hazards survival analysis.
RESULTS: The cohort included 2,346 AYAs; 80 (3%) with EDO; 32% White; 29% Hispanic, 15% Black. Mean age at LARC insertion 18.7 ± 2.4 years (range 12-25). Participants with EDO vs. without had higher odds of choosing intrauterine devices (IUD) over implants (OR = 2.18; 95% CI: 1.31, 3.61; p = .003). One-year LARC continuation rates were 77% overall and similar for those with and without EDOs. AYAs with EDOs vs without had similar likelihood of LARC device removal within 1 year. Participants identifying as Black non-Hispanic (OR = 0.34;95% CI: 0.26, 0.45, p < .001) and Hispanic (OR = 0.34; 95% CI: 0.26, 0.45, p < .001) vs White non-Hispanic had lower odds of choosing IUDs over implants. Black non-Hispanic AYAs had higher likelihood than White non-Hispanics for LARC removal within 1-year (HR = 1.58; 95% CI: 1.11, 2.25; p = .01).
CONCLUSIONS: AYAs with EDOs compared to those without EDOs are more likely to choose IUDs over implants and they have similar high 1-year LARC continuation rates . AYAs of non-White race/ethnicities independent of EDO diagnosis are less likely to choose IUDs.
METHODS: We used data on LARC insertions from 2017 to 2021 from four US adolescent medicine practices measuring demographics, menstrual history, reason for LARC device, follow-up, and continuation. Additional record search identified participants with EDOs. We examined associations of EDOs and choice of device using adjusted logistic regression and 1-year discontinuation using Cox proportional hazards survival analysis.
RESULTS: The cohort included 2,346 AYAs; 80 (3%) with EDO; 32% White; 29% Hispanic, 15% Black. Mean age at LARC insertion 18.7 ± 2.4 years (range 12-25). Participants with EDO vs. without had higher odds of choosing intrauterine devices (IUD) over implants (OR = 2.18; 95% CI: 1.31, 3.61; p = .003). One-year LARC continuation rates were 77% overall and similar for those with and without EDOs. AYAs with EDOs vs without had similar likelihood of LARC device removal within 1 year. Participants identifying as Black non-Hispanic (OR = 0.34;95% CI: 0.26, 0.45, p < .001) and Hispanic (OR = 0.34; 95% CI: 0.26, 0.45, p < .001) vs White non-Hispanic had lower odds of choosing IUDs over implants. Black non-Hispanic AYAs had higher likelihood than White non-Hispanics for LARC removal within 1-year (HR = 1.58; 95% CI: 1.11, 2.25; p = .01).
CONCLUSIONS: AYAs with EDOs compared to those without EDOs are more likely to choose IUDs over implants and they have similar high 1-year LARC continuation rates . AYAs of non-White race/ethnicities independent of EDO diagnosis are less likely to choose IUDs.