{
  "abstract": "Objective This study evaluates the impact of a multilevel postpartum family planning (PPFP) intervention on contraceptive use within 12 months postpartum and the prevention of short inter-pregnancy intervals in China.Methods This multicentre, cluster-randomised trial involved 36 hospitals in China. Hospitals were randomly assigned to either the intervention or control group. Eligible participants were women who were at least at 36 weeks gestation who gave birth at these hospitals, followed for up to 1 year. Between 1 July and 31 December 2019, the first 180 eligible women at each hospital were invited to participate. Control participants received routine antenatal and postnatal care, while the intervention group received integrated PPFP services, enhanced counselling and free contraceptives. The primary outcome was postpartum contraceptive use. Contraceptive prevalence, including any methods, long-acting reversible contraceptives (LARCs), method switching and unmet need was assessed using life table analysis and multilevel Cox regression.Results A total of 6315 participants were recruited, with 3116 in the intervention group and 3199 in the control group. The intervention group had higher contraceptive prevalence (88.7% vs 70.2%) and LARC uptake (21.4% vs 15.1%) at 12 months postpartum. Cox regression analysis showed a 1.88-fold increase in contraceptive use, a 2.64-fold increase in LARC uptake and a 48% reduction in unmet need for modern contraceptives in the intervention group. No significant differences in method switching were observed.Conclusions The multilevel PPFP intervention effectively increased contraceptive use and LARC uptake while reducing unmet need for modern contraceptives among postpartum women.Trial registration Chictr.org.cn Identifier: ChiCTR1900023790 (URL: https://www.chictr.org.cn/).",
  "authors": [
    {
      "affiliations": [
        "NHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, People's Republic of China"
      ],
      "name": "Xuhong Zhao"
    },
    {
      "affiliations": [
        "NHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, People's Republic of China"
      ],
      "name": "Xing Chen"
    },
    {
      "affiliations": [
        "NHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, People's Republic of China"
      ],
      "name": "Yuyan Li"
    },
    {
      "affiliations": [
        "NHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, People's Republic of China"
      ],
      "name": "Yan Zhang"
    },
    {
      "affiliations": [
        "Tianjin Hedong District Obstetrics and Gynecology Hospital, Tianjin, China"
      ],
      "name": "Dong Yuan"
    },
    {
      "affiliations": [
        "Department of Gynecology and Obstetrics, Northwest Women's and Children’s Hospital, Xi’an, China"
      ],
      "name": "Li Shan"
    },
    {
      "affiliations": [
        "Department of Obstetrics and Gynecology, Second affiliated Hospital of Chongqing Medical University, Chongqing, China"
      ],
      "name": "Xiaojing Dong"
    },
    {
      "affiliations": [
        "Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, China"
      ],
      "name": "Liqun Wang"
    },
    {
      "affiliations": [
        "School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China"
      ],
      "name": "Yuanzhong Zhou"
    },
    {
      "affiliations": [
        "Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, Sichuan, China"
      ],
      "name": "Weixin Liu"
    },
    {
      "affiliations": [
        "Human Sperm Bank, Urumqi Maternal and Child Health Care Hospital, Urumqi, Xinjiang, China"
      ],
      "name": "Xiaojun Wang"
    },
    {
      "affiliations": [
        "Henan Provincial Research Institute of Population and Family Planning, National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, Henan, China"
      ],
      "name": "Lifang Jiang"
    },
    {
      "affiliations": [
        "Department of Women's Health Children’s Health, Shanghai Center for Women’s, Shanghai, China"
      ],
      "name": "Xiaoyu Hu"
    },
    {
      "affiliations": [
        "Institute of Reproductive Health, Huazhong University of Science and Technology, Wuhan, Hubei, China"
      ],
      "name": "Wei Xia"
    },
    {
      "affiliations": [
        "Department of Gynecologic, Fujian Women and Child Health Hospital, Fuzhou, Fujian, China"
      ],
      "name": "Xiaochen Huang"
    },
    {
      "affiliations": [
        "Yunnan Population and Family Planning Research Institute, Kunming, Yunnan, China"
      ],
      "name": "Hanfeng Ye"
    },
    {
      "affiliations": [
        "Women’s Health Center, Changsha Hospital for Maternal and Child Health Care, Changsha, China"
      ],
      "name": "Yanfei Zhou"
    },
    {
      "affiliations": [
        "Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China"
      ],
      "name": "Jiandong Song"
    },
    {
      "affiliations": [
        "Maternal and Child Health Hospital of Guangxi Zhuangzu Autonomous Region, Nanning, Guangxi, China"
      ],
      "name": "Li Jiang"
    },
    {
      "affiliations": [
        "Department of Obstetrics and Gynecology, Jiangmen Maternal and Child Health Hospital, Jiangmen, Guangdong, China"
      ],
      "name": "Liangping Wang"
    },
    {
      "affiliations": [
        "NHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, People's Republic of China"
      ],
      "name": "Bingxue Wu"
    },
    {
      "affiliations": [
        "NHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, People's Republic of China"
      ],
      "name": "Yan Che"
    }
  ],
  "title": "Impact of multilevel postpartum family planning interventions on contraceptive use within 1 year after childbirth: a cluster-randomised controlled clinical trial",
  "uid": "86d81973-0e86-5a0c-86dd-52b6ed54a9f7"
}