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Pediatrics

Contraception in Women With Cardiovascular Disease

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JAMA

Published Online: July 22, 2022

JAMA Insights

Article Information and Disclosures

Kathryn J. Lindley, MD¹;

Stephanie B. Teal, MD, MPH²

Author Affiliations

¹Cardiovascular Division, Department of Medicine, Washington University in St Louis, St Louis, Missouri
²Department of Obstetrics and Gynecology and Reproductive Biology, University Hospitals Cleveland Medical Center, Cleveland, Ohio

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An increasing population of women of childbearing age have underlying congenital or acquired cardiovascular disease (CVD) in the US.¹^,2 For instance, among women aged 20 to 29 years, the prevalence of CVD (eg, coronary heart disease, heart failure, stroke, and hypertension) is estimated at 11.5%.³ The reasons for this include improved pediatric cardiac surgical care, which has enabled more than 90% of children with congenital heart disease to survive to adulthood, and increasing rates of cardiovascular (CV) risk factors among young women (eg, obesity, hypertension, and diabetes).²

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Article Information

Corresponding Author: Stephanie B. Teal, MD, MPH, Department of Obstetrics and Gynecology and Reproductive Biology, University Hospitals Cleveland Medical Center, 11100 Euclid St, MAC-5034, Cleveland, OH 44106 (stephanie.teal@uhhospitals.org).

Published Online: July 22, 2022. doi:10.1001/jama.2022.11541

Conflict of Interest Disclosures: Dr Teal reported honoraria from Merck & Co (data and safety monitoring board) and Bayer Healthcare (scientific advisory board); and grants to her institution while serving as principal investigator from Merck & Co, Bayer Healthcare, Sebela, Medicines 360, and Chemo Research outside the submitted work. No other disclosures were reported.

References

Lindley KJ , Bairey Merz CN , Davis MB , et al. Contraception and reproductive planning for women with cardiovascular disease. J Am Coll Cardiol. 2021;77(14):1823-1834.PubMed Google Scholar Crossref

Lindley KJ , Bairey Merz CN , Asgar AW , et al. Management of women with congenital or inherited cardiovascular disease from pre-conception through pregnancy and postpartum. J Am Coll Cardiol. 2021;77(14):1778-1798.PubMed Google Scholar Crossref

Benjamin EJ , Virani SS , Callaway CW , et al. Heart disease and stroke statistics - 2018 update. Circulation. 2018;137(12):e67-e492. PubMed Google Scholar Crossref

Davis MB , Arendt K , Bello NA , et al. Team-based care of women with cardiovascular disease from pre-conception through pregnancy and postpartum. J Am Coll Cardiol. 2021;77(14):1763-1777.PubMed Google Scholar Crossref

ACOG Practice Bulletin No. 206 Summary: use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol. 2019;133(2):396-399. doi:10.1097/AOG.0000000000003073 PubMed Google Scholar Crossref

Kavanaugh ML , Pliskin E . Use of contraception among reproductive-aged women in the United States, 2014 and 2016. F S Rep. 2020;1(2):83-93. PubMed Google Scholar

Teal S , Edelman A. Contraception selection, effectiveness, and adverse effects. JAMA. 2021;326(24):2507-2518. doi:10.1001/jama.2021.21392 PubMed Google Scholar Crossref

Curtis KM , Tepper NK , Jatlaoui TC , et al. US medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep. 2016;65(3):1-103.PubMed Google Scholar Crossref

Tepper NK , Whiteman MK , Marchbanks PA , James AH , Curtis KM . Progestin-only contraception and thromboembolism. Contraception 2016;94(6):678-700. doi:10.1016/j.contraception.2016.04.014 PubMed Google Scholar Crossref

Castillo K , Zambrano K , Barba D , et al Long-acting reversible contraceptives effects in abnormal uterine bleeding. Eur J Obstet Gynecol Reprod Biol. 2022;270:231-238. doi:10.1016/j.ejogrb.2022.01.020 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.