Association between knowledge about levonorgestrel emergency contraception and the risk of ectopic pregnancy following levonorgestrel emergency contraception failure: a comparative survey

Pharmacoepidemiol Drug Saf. 2016 Aug;25(8):880-8. doi: 10.1002/pds.3946. Epub 2016 Jan 8.

Abstract

Objective: To study the association between knowledge about levonorgestrel emergency contraception (LNG-EC) and the risk of ectopic pregnancy (EP) following LNG-EC failure.

Methods: This study included 600 women who had visited the hospital with LNG-EC failure. Of these, 300 with EP and 300 with intrauterine pregnancy (IUP) were recruited to the EP group and IUP group respectively. The participants were interviewed face-to-face using a standardized questionnaire.

Main outcome measures: Pearson's chi-square tests and t-test were used to compare the sociodemographic characteristics, reproductive and gynecological history, surgical history, previous contraceptive experience, and answers to 10 questions concerning the knowledge about LNG-EC.

Results: Those who gave incorrect answers to the question regarding the basic mechanism and specific method of levonorgestrel emergency contraceptive pills (LNG-ECPs) were at a higher risk of EP after LNG-EC failure. Women who did not strictly follow instructions or advice from healthcare professionals were more likely to subsequently experience EP (p < 10(-4) ). Women with LNG-EC failure reported friends/peers, TV, and Internet as the main sources of information. No difference was observed with regard to the sources of knowledge on LNG-EC (p = 0.07).

Conclusions: The results illustrate the importance of strictly following the doctor's guidance or drug instructions when using LNG-ECPs. The media should be used to disseminate information about responsible EC, and pharmacy staff should receive regular educational training sessions in this regard. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.

Keywords: contraceptive failure; ectopic pregnancy; emergency contraception; knowledge; levonorgestrel; pharmacoepidemiology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Contraception, Postcoital / methods*
  • Contraceptives, Postcoital / administration & dosage*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Levonorgestrel / administration & dosage*
  • Patient Education as Topic / methods
  • Pregnancy
  • Pregnancy, Ectopic / epidemiology*
  • Surveys and Questionnaires
  • Treatment Failure
  • Young Adult

Substances

  • Contraceptives, Postcoital
  • Levonorgestrel