{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:53:12Z","timestamp":1792788792240,"version":"4.5.0"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T00:00:00Z","timestamp":1710720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"USAID","award":["7200GH21IO00005"],"award-info":[{"award-number":["7200GH21IO00005"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite conflicting findings in the current literature regarding the correlation between contraceptives and maternal health consequences, statistical analyses indicate that family planning may decrease the occurrence of such outcomes. Consequently, it is crucial to assess the capability of family planning to mitigate adverse maternal health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This review investigates the effects of modern contraceptive use on maternal health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Search methods<\/jats:title>\n                    <jats:p>This systematic review is registered on Prospero (CRD42022332783). We searched numerous databases with an upper date limit of February 2022 and no geographical boundaries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Selection criteria<\/jats:title>\n                    <jats:p>We included observational studies, including cross-sectional, cohort, case-control studies, and non-RCT with a comparison group. We excluded systematic reviews, scoping reviews, narrative reviews, and meta-analyses from the body of this review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Main results<\/jats:title>\n                    <jats:p>The review included nineteen studies, with five studies reporting a reduction in maternal mortality linked to increased access to family planning resources and contraceptive use. Another three studies examined the impact of contraception on the risk of preeclampsia and our analysis found that preeclampsia risk was lower by approximately 6% among contraceptive users (95% CI 0.82\u20131.13) compared to non-users. Two studies assessed the effect of hormonal contraceptives on postpartum glucose tolerance and found that low-androgen contraception was associated with a reduced risk of gestational diabetes (OR 0.84, 95% CI 0.58\u20131.22), while DMPA injection was possibly linked to a higher risk of falling glucose status postpartum (OR 1.42, 95% CI 0.85\u20132.36). Two studies evaluated high-risk pregnancies and births in contraceptive users versus non-users, with the risk ratio being 30% lower among contraceptive users of any form (95% CI 0.61, 0.80). None of these results were statistically significant except the latter. In terms of adverse maternal health outcomes, certain contraceptives were found to be associated with ectopic pregnancy and pregnancy-related venous thromboembolism through additional analysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0294475","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T13:34:24Z","timestamp":1710768864000},"page":"e0294475","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["A meta-analysis into the mediatory effects of family planning utilization on complications of pregnancy in women of reproductive age"],"prefix":"10.1371","volume":"19","author":[{"given":"Shayesteh","family":"Jahanfar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0132-0454","authenticated-orcid":true,"given":"Olivia","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Lapidow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali Rajkumari","family":"Oberoi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Steinfeldt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6949-8976","authenticated-orcid":true,"given":"Moazzam","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"key":"pone.0294475.ref001","unstructured":"\u201cUnmet Need for Contraception: Fact Sheet.\u201d PRB, https:\/\/www.prb.org\/resources\/unmet-need-for-contraception-fact-sheet\/. Accessed 16 Oct. 2022."},{"key":"pone.0294475.ref002","unstructured":"Sedgh, Gilda, et al. Unmet Need for Contraception in Developing Countries: Examining Women\u2019s Reasons for Not Using a Method. June 2016. www.guttmacher.org, https:\/\/www.guttmacher.org\/report\/unmet-need-for-contraception-in-developing-countries."},{"key":"pone.0294475.ref003","unstructured":"World Health Organization, 2023. Maternal mortality. [cited 2023 Nov 10]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/maternal-mortality."},{"issue":"5","key":"pone.0294475.ref004","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s10995-009-0505-y","article-title":"How Increased Contraceptive Use Has Reduced Maternal Mortality","volume":"14","author":"John Stover","year":"2010","journal-title":"Maternal and Child Health Journal"},{"issue":"9837","key":"pone.0294475.ref005","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S0140-6736(12)60478-4","article-title":"Maternal Deaths Averted by Contraceptive Use: An Analysis of 172 Countries","volume":"380","author":"Saifuddin Ahmed","year":"2012","journal-title":"The Lancet"},{"issue":"9","key":"pone.0294475.ref006","doi-asserted-by":"crossref","first-page":"e1152","DOI":"10.1016\/S2214-109X(20)30315-6","article-title":"Unintended Pregnancy and Abortion by Income, Region, and the Legal Status of Abortion: Estimates from a Comprehensive Model for 1990\u20132019","volume":"8","author":"Jonathan Bearak","year":"2020","journal-title":"The Lancet Global Health"},{"key":"pone.0294475.ref007","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1363\/46e9020","article-title":"Estimates of the Potential Impact of the COVID-19 Pandemic on Sexual and Reproductive Health in Low- and Middle-Income Countries","volume":"46","author":"Taylor Riley","year":"2020","journal-title":"International Perspectives on Sexual and Reproductive Health"},{"issue":"9837","key":"pone.0294475.ref008","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S0140-6736(12)60609-6","article-title":"Contraception and Health","volume":"380","author":"John Cleland","year":"2012","journal-title":"The Lancet"},{"issue":"3","key":"pone.0294475.ref009","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1186\/1742-4755-11-S3-S1","article-title":"Preconception Care: Closing the Gap in the Continuum of Care to Accelerate Improvements in Maternal, Newborn and Child Health","volume":"11","author":"Sohni V. Dean","year":"2014","journal-title":"Reproductive Health"},{"key":"pone.0294475.ref010","first-page":"5580490","article-title":"Postpartum Family Planning Use and Its Determinants among Women of the Reproductive Age Group in Low-Income Countries of Sub-Saharan Africa: A Systematic Review and Meta-Analysis","volume":"2021","author":"Tesfalem Tilahun Yemane","year":"2021","journal-title":"International Journal of Reproductive Medicine"},{"issue":"1","key":"pone.0294475.ref011","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1186\/s12978-021-01195-8","article-title":"Utilization and Its Factors of Post Abortion Modern Contraceptive in Ethiopia: A Systematic Review and Meta-Analysis","volume":"18","author":"Fentahun Yenealem Beyene","year":"2021","journal-title":"Reproductive Health"},{"issue":"3","key":"pone.0294475.ref012","article-title":"Hormonal versus Non-Hormonal Contraceptives in Women with Diabetes Mellitus Type 1 and 2","volume":"2013","author":"Jantien Visser","year":"2013","journal-title":"The Cochrane Database of Systematic Reviews"},{"issue":"9","key":"pone.0294475.ref013","article-title":"Integration of HIV\/AIDS Services with Maternal, Neonatal and Child Health, Nutrition, and Family Planning Services","author":"Mary Lou Lindegren","year":"2012","journal-title":"The Cochrane Database of Systematic Reviews"},{"issue":"1","key":"pone.0294475.ref014","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1080\/07853890.2021.2020893","article-title":"Integration of Family Planning into HIV Services: A Systematic Review","volume":"54","author":"Luka Nkhoma","year":"2022","journal-title":"Annals of Medicine"},{"key":"pone.0294475.ref015","first-page":"1491419","article-title":"Factors Associated with Ruptured Ectopic Pregnancy: A 10-Year Review at a District Hospital in Ghana","volume":"2022","author":"Promise E. Sefogah","year":"2022","journal-title":"Obstetrics and Gynecology International"},{"issue":"9","key":"pone.0294475.ref016","first-page":"844","article-title":"Risk Factors for Ectopic Pregnancy: A Case\u2013Control Study","volume":"19","author":"Ashraf Moini","year":"2014","journal-title":"Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences"},{"issue":"6","key":"pone.0294475.ref017","doi-asserted-by":"crossref","first-page":"e0130077","DOI":"10.1371\/journal.pone.0130077","article-title":"Scaling Up Family Planning to Reduce Maternal and Child Mortality: The Potential Costs and Benefits of Modern Contraceptive Use in South Africa","volume":"10","author":"Lumbwe Chola","year":"2015","journal-title":"PloS One"},{"issue":"6","key":"pone.0294475.ref018","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1136\/jech.52.6.377","article-title":"The Feasibility of Creating a Checklist for the Assessment of the Methodological Quality Both of Randomised and Non-Randomised Studies of Health Care Interventions","volume":"52","author":"S. 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Contraception"},{"key":"pone.0294475.ref031","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/s12884-015-0613-1","article-title":"Risk Factors for Ectopic Pregnancy: A Multi-Center Case-Control Study","volume":"15","author":"Cheng Li","year":"2015","journal-title":"BMC Pregnancy and Childbirth"},{"key":"pone.0294475.ref032","first-page":"214","article-title":"Levonorgestrel Only Emergency Contraceptive Use and Risk of Ectopic Pregnancy in Eldoret Kenya: A Case-Control Study","volume":"31","author":"Sahara Shurie","year":"2018","journal-title":"The Pan African Medical Journal"},{"issue":"10","key":"pone.0294475.ref033","doi-asserted-by":"crossref","first-page":"e0205239","DOI":"10.1371\/journal.pone.0205239","article-title":"Abortion in Zimbabwe: A national study of the incidence of induced abortion, unintended pregnancy and post-abortion care in 2016","volume":"13","author":"EA Sully","year":"2018","journal-title":"PLoS ONE"},{"issue":"5","key":"pone.0294475.ref034","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.2337\/dc06-2227","article-title":"Androgenicity of progestins in hormonal contraceptives and the risk of gestational diabetes mellitus","volume":"30","author":"MM Hedderson","year":"2007","journal-title":"Diabetes Care"},{"issue":"6","key":"pone.0294475.ref035","doi-asserted-by":"crossref","first-page":"699.e1-7","DOI":"10.1016\/j.ajog.2008.03.029","article-title":"Intermediate-term glucose tolerance in women with a history of gestational diabetes: natural history and potential associations with breastfeeding and contraception","volume":"198","author":"AL Nelson","year":"2008","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"pone.0294475.ref036","first-page":"325","article-title":"Low dosage oral contraception in women with previous gestational diabetes","volume":"59","author":"SO Skouby","year":"1982","journal-title":"Obstet Gynecol"},{"issue":"1","key":"pone.0294475.ref037","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1080\/13625180500039084","article-title":"Oral contraceptives use and weight gain in women with a Central European life-style","volume":"10","author":"MM Lech","year":"2005","journal-title":"Eur J Contracept Reprod Health Care"},{"issue":"1","key":"pone.0294475.ref038","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1160\/TH13-09-0797","article-title":"Combined hormonal contraception and risk of venous thromboembolism within the first year following pregnancy. Danish nationwide historical cohort 1995\u20132009","volume":"112","author":"JF Petersen","year":"2014","journal-title":"Thromb Haemost"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0294475","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T13:35:00Z","timestamp":1710768900000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0294475"}},"subtitle":[],"editor":[{"given":"Ayodeji Babatunde","family":"Oginni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,3,18]]},"references-count":38,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0294475","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,18]]}}}