Teens with CHD are less likely than peers to receive contraception

Teens with CHD are less likely than peers to receive contraception | Image credit: Contemporary Pediatrics

Despite their elevated risk of complications during pregnancy and delivery, young women with congenital heart disease (CHD) are less likely to receive contraception than those without CHD. This was the chief finding of an analysis of data involving female patients aged 14 to 21 years with CHD compared with young women of a similar age without the disease seen at a tertiary care center. Investigators analyzed data during the 6.5-year study period for a total of 12,368 visits from 7819 patients. Of those visits, 698 (6%) were patients with simple CHD, 1357 (11%) were patients with moderate CHD, 243 (2%) were patients with complex CHD, and 146 (1%) were patients with single ventricle (SV) CHD.

Specific patient characteristics were associated with the likelihood of receiving contraceptives. For example, those on contraception were significantly older (median age, 17 years vs 16 years) and more likely to be White than those who were not. Diagnosis also made a difference, with the highest rate of contraception seen in those with complex CHD (30%); those with simple CHD had the lowest (19%). However, the percentage of patients on contraception steadily increased over the study period, regardless of diagnosis. Nonetheless, patients with CHD were significantly less likely to be prescribed contraception than patients without CHD, though both increased age and later year of visit increased those odds. As to the type of contraception chosen, those with no or less complex CHD were most likely to use oral contraceptive pills, whereas most patients with SV CHD who were on contraception used a form of long-acting reversible contraception (55%). This was a far greater percentage than other groups that used long-acting reversible contraception: those without CHD (18%), with simple CHD (17%), with moderate CHD (16%), or with complex CHD (46%).

THOUGHTS FROM DR FARBER

Patients with CHD may be more likely to have complications from pregnancy, and CHD is generally not a contraindication to contraception. Do not assume the cardiologist is handling this; make sure that your patients who would benefit from contraception receive it.

Reference

Giafaglione J, Mah ML, Wright LK. Contraception use in adolescents and young adults with congenital heart disease. Pediatr Cardiol. Published online March 3, 2025. doi:10.1007/soo246-025-03791-y