Rapid Repeat Pregnancy and Contraceptive Uptake: A Retrospective Cohort Study [7N]

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Abstract

INTRODUCTION:

Rapid repeat pregnancy, a pregnancy occurring within 18 months of a prior delivery, accounts for one third of all pregnancies in the United States. Short inter-pregnancy intervals are associated with poor health outcomes. This study seeks to identify factors associated with rapid repeat pregnancy.

METHODS:

This retrospective cohort study identified all women who delivered a live birth at a Montefiore Medical Center in 2012. Patient demographics, and contraceptive use and initiation in the postpartum period were abstracted from medical records and multivariate logistic regression was used to analyze association with rapid repeat pregnancy.

RESULTS:

Among the women who had a birth in 2012 (N=6210), 5.7% had a rapid repeat delivery within 24 months. Attending an outpatient visit for contraceptive initiation (OR 0.59, 95% CI 0.43–0.80), age 31–40 (OR 0.72, 95% CI 0.55–0.95), and Cesarean delivery (OR 0.67, 95% CI 0.53–0.87) were associated with a significantly decreased risk of a rapid repeat pregnancy. Notably, receiving Depo-Provera (OR 0.92, 95% CI 0.61–1.38) or a prescription for Progestin contraceptive pills (OR 1.23, 95% CI 0.94–1.63) prior to discharge from the hospital were not significantly associated with a decreased risk of rapid repeat pregnancy.

CONCLUSION:

Women who attended an outpatient visit for contraceptive initiation were significantly less likely to have a rapid repeat delivery. Patients who received Depo-Provera or Progestin contraceptive pills had no reduction in the incidence of rapid repeat delivery. These data suggest that increased emphasis should be placed on outpatient encounters for contraceptive management in the postpartum period.

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