Category: Education/Simulation
Poster Session II
Education is a critical component of comprehensive patient-centered care and improves reproductive autonomy. Previously we reported the results of a trial (NCT04291040) which randomized high-risk pregnancies to an intervention with a multimedia based educational tool (MET) compared to routine care (RC) to assess the use of long-acting reversible contraception (LARC) at 12 weeks postpartum (Qureshey EJ et al Obstet Gynecol;2022:139;571-8). Herein, we aimed to report a priori pre-planned 1-year follow-up of the cohorts.
Study Design: In the parent trial, 380 individuals were randomized (190 to MET and 190 to RC group). Individuals in MET received a multimedia based educational intervention. Electronic surveys were scheduled and automatically sent to all participants at 3-month intervals following delivery. Data from the 12-month postpartum survey were analyzed. The primary purpose of this analysis was to ascertain use of LARC at 1-year; secondary outcomes were satisfaction with method of contraception and repeat pregnancies within a year. Relative risk (RR), number needed to treat (NNT) and 95% confidence intervals (CI) were calculated.
Results: Overall, one-year follow-up was obtained in 309 (81%) individuals—152 (80%) in MET and 157 (83%) in RC—who enrolled in the parent trial. Participants who followed up were more likely to have previously used LARC as contraception (24% vs. 11% P= 0.017) and to be privately insured (17.8% vs. 5.6% P= 0.033), compared to those who did not follow up. At the 1-year follow-up, contraceptive usage was significantly higher in the MET compared to the RC (81.6% vs. 70.7% P=0.025 RR 1.15 95% CI 1.02-1.31 NNT 9; Table 1). Satisfaction with the method of contraception was similar between the groups (80.3% vs 79.6%; P=0.887; Table 1). There was a trend towards decreased short interval pregnancy in the MET group compared to RC (7.2% vs 11.4% RR 0.64 95% CI 0.31-1.30; Table 2).
Conclusion: Compared to routine care, the use of a multimedia-based education tool increased the overall use of contraception at 1 year postpartum in patients with an antecedent high-risk pregnancy.
Claudia Ibarra, BS, MD, MPH
Maternal Fetal Medicine Fellow
University of Texas Health Science Center-Houston Medical School
Houston, Texas, United States
Emma J. Qureshey, MD
Department of Obstetrics, Gynecology and Reproductive Sciences McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States
Han-Yang Chen, PhD
Department of Obstetrics, Gynecology and Reproductive Sciences
McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States
Stephen M. Wagner, MD
Assistant Professor
Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
Sunbola Ashimi, PhD
Department of Obstetrics, Gynecology and Reproductive Sciences McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States
Patti Jayne Ross, MD
Department of Obstetrics, Gynecology and Reproductive Sciences McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Tennessee, United States
Sean C. Blackwell, MD
Professor
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States
Baha M. Sibai, MD
Professor
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States
Suneet P. Chauhan, MD
Professor
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
Houston, Texas, United States