Documented contraceptive use after delivery in women with pre-gestational and gestational diabetes in Thailand: a single center study

Purpose To determine the contraceptive prevalence rate in postpartum women with diabetes complicating pregnancy. Materials and methods This retrospective study included women diagnosed with gestational diabetes (GDM) and pre-existing diabetes (PDM) who delivered at Siriraj Hospital during January 2016 to December 2019. Contraceptive use during the 6 months postpartum period was reviewed and compared between the diabetes groups. Results A total of 1539 women were enrolled, including 1466 women with GDM and 73 women with PDM. The overall contraceptive prevalence rate was 78.7%, which was not different between the diabetes groups (PDM 75.4% vs. GDM 78.9%, OR 0.95; 95% CI 0.83-1.09). The commonly used methods were sterilization (34.8%), progestin injection (15.2%) and condom (10.9%). Sterilization was more prevalent in PDM (PDM 56.2% vs. GDM 33.8%, OR 1.66; 95% CI 1.34-2.06) and a modern reversible method was infrequently used in women with PDM (PDM 19.2% vs. GDM 45.1%, OR 0.42; 95% CI 0.26-0.68). Among non-sterilization, the odds of contraceptive use was significantly lower in PDM (OR 0.64, 95% CI 0.43-0.95). Conclusions Women with DM-complicated pregnancy frequently used contraception after delivery. However, the rate of modern contraceptive use among non-sterilized women was lower in those with PDM and the chosen methods were still inappropriate. Our findings highlight potential opportunities to improve contraceptive care and the need to promote the use of highly effective methods, seeking to minimize barriers for modern reversible contraceptive accessing.