{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T04:19:40Z","timestamp":1769055580794,"version":"3.49.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":1530,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["1K23HL151816-01A1"],"award-info":[{"award-number":["1K23HL151816-01A1"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"crossref","award":["1K23HL151816-01A1"],"award-info":[{"award-number":["1K23HL151816-01A1"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney transplant improves reproductive function in women with end-stage kidney disease. Little is known about contraceptive use in women with history of kidney transplants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from the United States Renal Data System, we evaluated for each calendar year women with kidney transplantation between 1\/1\/2005 and 12\/31\/2013 who were aged 15\u201344\u00a0years with Medicare as the primary payer and linked data from the United Network for Organ Sharing, for up to three entire years after the date of transplantation. We determined rates of contraceptive use and used multivariable logistic regression to identify factors associated with contraceptive use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study cohort included 13,150 women and represented 26,624 person-years. The rate of contraceptive use was 9.5%. Compared to women aged 15\u201324\u00a0years, contraceptive use was lower in women aged 30\u201334\u00a0years (OR 0.67; CI 0.58\u20130.78), 35\u201339\u00a0years (OR 0.36; CI 0.31\u20130.43), and 40\u201344\u00a0years (OR 0.23; CI 0.19\u20130.28). Compared to white women, contraceptive use was higher both in black women (OR 1.26; CI 1.10\u20131.43) and Native American women (OR 1.52; CI 1.02\u20132.26). Women had lower rates of contraceptive use in the second-year post-transplant (OR 0.87; CI 0.79\u20130.94) and the third-year post-transplant (OR0.69; CI 0.62\u20130.76) than in the first-year post-transplant. Women with a history of diabetes had a lower likelihood of contraceptive use (OR 0.80; CI 0.65\u20130.99).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among women with kidney transplants, contraceptive use remains low at 9.5%. Factors associated with a higher likelihood of contraceptive use include younger age and black and Native American race\/ethnicity; and second- and third-year post-transplant. The history of diabetes is associated with a lower likelihood of contraceptive use. The study highlights the need of increasing awareness for safe and effective contraceptive use in women with kidney transplants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-021-01181-0","type":"journal-article","created":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T05:02:23Z","timestamp":1636779743000},"page":"629-638","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Contraceptive use among women with kidney transplants in the United States"],"prefix":"10.1093","volume":"35","author":[{"given":"Silvi","family":"Shah","sequence":"first","affiliation":[{"name":"Division of Nephrology, Kidney C.A.R.E. (Clinical Advancement, Research and Education) Program, University of Cincinnati, 231 Albert Sabin Way, MSB 6112, Cincinnati,OH 45267, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette L.","family":"Christianson","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shalini","family":"Bumb","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Kidney C.A.R.E. (Clinical Advancement, Research and Education) Program, University of Cincinnati, 231 Albert Sabin Way, MSB 6112, Cincinnati,OH 45267, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prasoon","family":"Verma","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center, Cincinnati,OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,11,13]]},"reference":[{"key":"2026012108033978300_CR1","doi-asserted-by":"publisher","first-page":"4539342","DOI":"10.1155\/2016\/4539342","article-title":"overview of pregnancy in renal transplant patients","volume":"2016","author":"Shah","year":"2016","journal-title":"Int J Nephrol"},{"key":"2026012108033978300_CR2","doi-asserted-by":"publisher","first-page":"e0220916","DOI":"10.1371\/journal.pone.0220916","article-title":"Racial disparities and factors associated with pregnancy in kidney transplant recipients in the United States","volume":"14","author":"Shah","year":"2019","journal-title":"PLoS\u00a0One"},{"key":"2026012108033978300_CR3","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s12882-019-1213-5","article-title":"Pregnancy outcomes in women with kidney transplant: metaanalysis and systematic review","volume":"20","author":"Shah","year":"2019","journal-title":"BMC Nephrol"},{"key":"2026012108033978300_CR4","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1007\/s40620-018-0499-x","article-title":"A best-practice position statement on pregnancy after kidney transplantation: focusing on the unsolved questions. 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The results presented in this paper have not been published previously in whole or part, except in abstract format. The data reported here have been supplied by the United States Renal Data System (USRDS). The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as official policy or interpretation of the US government.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All the authors have no disclosures and competing interests. The results presented in this paper have not been published previously in whole or part, except in abstract format. The data reported here have been supplied by the United States Renal Data System (USRDS). Due to use of the de-identified data, the University of Cincinnati Institutional Review Board committee deemed the study exempt from requiring informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}