The US Centers for Disease Control and Prevention has released revised recommendations for postpartum contraceptive use based on an assessment of new evidence, announced an article published in the July 8 issue of Morbidity and Mortality Weekly Report.
The U.S. Centers for Disease Control and Prevention (CDC) has released revised recommendations for postpartum contraceptive use based on an assessment of new evidence, announced an article published in the July 8 issue of Morbidity and Mortality Weekly Report.
The guidelines, which update the CDC's U.S. Medical Eligibility Criteria for Contraceptive Use, 2010, recommend that postpartum women should not use combined hormonal contraceptives during the first 21 days after delivery because of the high risk for venous thromboembolism (VTE).
“Use of combined hormonal contraceptives (during this time) represents an unacceptable health risk and should not be used (category 4),” the statement said.
Women without risk factors for VTE, such as previous VTE or recent cesarean delivery, generally can initiate combined hormonal contraceptives among postpartum days 21 to 42; women with risk factors should not use combined hormonal contraceptives during this time as the risks usually outweigh the advantages (category 3). After 42 days, there are no recommended restrictions on contraceptive use, the report said.
Category 3 is characterized as a condition for which the theoretical or proven risks usually outweigh the contraceptive method’s advantages. Category 4 is a condition that represents an unacceptable health risk if the contraceptive method is used.
Published in 2010, the CDC’s original guidelines, which were adapted from World Health Organization (WHO) guidelines, recommended that combined hormonal contraceptives generally should not be used in women less than 21 days postpartum, but after that time, they could be used without restriction.
The CDC initiated an assessment to evaluate whether its guidelines should be updated in line with WHO’s recently updated guidelines, which was based on a review of evidence from 13 studies that found:
Separate recommendations for the use of combined hormonal contraceptives among women who are breastfeeding remain unchanged, as do the recommendations for use of other contraceptives, including progestin-only hormonal contraceptives.
“Healthcare providers assessing a woman's individual risk also should consider any other characteristics or medical conditions that might impact the classification,” the authors wrote. “For postpartum women, this might include examining the recommendations for other risk factors for VTE, such as known thrombogenic mutations (category 4) or history of VTE with risk factors for recurrence (category 4), both of which pose an unacceptable health risk for combined hormonal contraceptive use, whether or not women are postpartum.”
Pharmacists Play Unique Role in Advancing Health Equity for Patients With Chronic Disease
December 7th 2023A new study, outlined in a poster at ASHP Midyear 2023, identified 3 key themes associated with the ways in which pharmacists are positioned to advance health equity for patients with chronic diseases.
Assessing Financial Impacts of Pharmacist-Led Interventions in Pediatric Ambulatory Care
December 5th 2023According to a poster abstract presented at the ASHP Midyear Clinical Meeting & Exhibition, specialty pharmacy services were used for a variety of conditions that have been reported in adult populations.