Abstract
Objective
Systematically review the existing evidence about couples-based interventions and
postpartum contraceptive uptake and generate recommendations for future research.
Data sources
PubMed, Web of Science, PsycINFO, Embase, and CINAHL through June 7, 2021.
Study selection and data extraction
Studies with a couples-based intervention assessing postpartum contraceptive uptake.
Two independent reviewers screened studies, extracted data, and assessed risk of bias
with RoB-2 (Cochrane Risk of Bias 2) for randomized and ROBINS-I (Risk of Bias in
Non-Randomized Studies – Interventions) for observational studies. Data were synthesized
in tables, figures, and a narrative review.
Results
A total of 925 papers were identified, 66 underwent full text review, and 17 articles,
which included 18 studies – 16 randomized, 2 observational – were included. The lack
of intervention and outcome homogeneity precluded meta-analysis and isolating the
effect of partner involvement. Four studies were partner-required, where partner involvement
was a required component of the intervention, and 14 were partner-optional. Unadjusted
risk differences ranged from 0.01 to 0.51 in favor of couples-based interventions
increasing postpartum contraceptive uptake versus standard of care. Bias assessment
of the 16 randomized studies classified 8, 3, and 5 studies as at a high, some concern,
and low risk of bias. Common sources of bias included intervention non-adherence and
missing outcome data. One observational study was at a high and the other at a low
risk of bias.
Conclusions
Future studies that assess couples-based interventions must clearly define and measure
how partners are involved in the intervention and assess how intervention adherence
impacts postpartum contraceptive uptake.
Keywords
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Article info
Publication history
Published online: May 13, 2022
Accepted:
May 2,
2022
Received in revised form:
April 29,
2022
Received:
September 23,
2021
Footnotes
PROSPERO ID: CRD42021250358.
Registration: PROSPERO (CRD42021250358).
Declaration of Competing Interest: None declared.
Funding: DES is supported by the National Institute of Mental Health of the National Institutes of Health [F30MH123219] and by NIGMS of the National Institutes of Health [T32GM007347]. LSP is supported by the National Institutes of Allergy and Infectious Diseases [F31AI152614-01A1]. CMA is supported by the National Institute of Mental Health [K01MH107255; R01MH113478]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This project used REDCap, which is supported by CTSA award number UL1TR002243 from the National Center for Advancing Translational Sciences.
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