Papers by caroline moreau
Journal of Adolescent Health, Jul 1, 2023
Obstetrics and gynecology, 2007
To examine the frequencies of reported symptoms by oral contraceptive pill (OCP) composition amon... more To examine the frequencies of reported symptoms by oral contraceptive pill (OCP) composition among French women.
BMJ, 2010
Objectives To analyse the association between body mass index (BMI) and sexual activity, sexual s... more Objectives To analyse the association between body mass index (BMI) and sexual activity, sexual satisfaction, unintended pregnancies, and abortions in obese people and to discuss the implications for public health practices, taking into account the respondents' and their partners' BMI. Design Random probability survey of sexual behaviours. Setting National population based survey of 12 364 men and women aged 18-69 living in France in 2006. Participants Random selection of 5535 women and 4635 men, of whom 3651 women and 2725 men were normal weight (BMI 18.5-<25), 1010 women and 1488 men were overweight (BMI 25-<30), and 411 women and 350 men were obese (BMI >30). Results Obese women were less likely than normal weight women to report having a sexual partner in the past 12 months (odds ratio 0.71, 95% confidence interval 0.51 to 0.97). Obese men were less likely than normal weight men to report more than one sexual partner in the same period (0.31, 0.17 to 0.57, P<0.001) and more likely to report erectile dysfunction (2.58, 1.09 to 6.11, P<0.05). Sexual dysfunction was not associated with BMI among women. Obese women aged under 30 were less likely to seek healthcare services for contraception (0.37, 0.18 to 0.76) or to use oral contraceptives (0.34, 0.15 to 0.78). They were also more likely to report an unintended pregnancy (4.26, 2.21 to 8.23). Conclusion There is a link between BMI and sexual behaviour and adverse sexual health outcomes, with obese women less likely to access contraceptive healthcare services and having more unplanned pregnancies. Prevention of unintended pregnancies among these women is a major reproductive health challenge. Healthcare professionals need to be aware of sensitivities related to weight and gender in the provision of sexual health services.
Human Reproduction, 2006
BACKGROUND: Despite the widespread use of highly effective contraception in France, the incidence... more BACKGROUND: Despite the widespread use of highly effective contraception in France, the incidence of abortion is high. A retrospective population-based cohort study was designed to analyse women's contraceptive history. METHOD: We compared the contraceptive use of 163 women, whose last pregnancy ended in abortion, 6 months before, at the time of, 1 month and 6 months after the event with that of 1787 women who had never had an abortion. RESULTS: A total of 46% of women who experienced an abortion used a highly effective form of contraception 6 months before the event (versus 76% among women who had never had an abortion, P < 0.001). This proportion dropped to 33% at the time of the abortion and increased to 71%, 1 month after. In addition, 50% of women who had an abortion had changed their contraceptive method in the 6 months before the event (compared with 16% in the 6 months before the interview in women who had not had an abortion, P < 0.001). Women with socially deprived backgrounds were less likely to use a highly effective contraception after an abortion. CONCLUSIONS: Abortion is a good opportunity for intervention, but especially so for socially disadvantaged women. It is essential to draw the attention of prescribers and women to the higher risk of contraceptive failure at the start of use of a method.
Journal of Adolescent Health, 2013
Purpose-We prospectively examined the influence of young women's depression and psychological str... more Purpose-We prospectively examined the influence of young women's depression and psychological stress symptoms on their weekly contraceptive method use. Methods-We examined data from 689 women ages 18-20 years participating in a longitudinal cohort study. Women completed 8,877 weekly journals over the first year, which assessed reproductive, relationship and health information. We focused on baseline depression (Center for Epidemiologic Studies-Depression Scale) and stress (Perceived Stress Scale) symptoms and weekly contraceptive method use. Analyses used multivariate random effects and multinomial logistic regression. Results-Approximately, one-quarter of women exhibited moderate/severe depression (27%) and stress (25%) symptoms at baseline. Contraception was not used in 10% of weekly journals, while coital and noncoital methods were used in 42% and 48% of weeks, respectively. In adjusted models, women with moderate/severe stress symptoms had over twice the odds of contraception nonuse than women without stress (OR 2.23, CI 1.02-4.89, p=0.04). Additionally, women with moderate/severe depression (RR 0.52, CI 0.40-0.68, p<0.001) and stress (RR 0.75, CI 0.58-0.96, p=0.02) symptoms had lower relative risks of using long-acting methods than OCs (reference category). Women with stress symptoms also had higher relative risks of using condoms (RR 1.17, CI 1.00-1.34, p=0.02) and withdrawal (RR 1.29, CI 1.10-1.51, p=0.001) than
The European Journal of Public Health, 2004
Background: With an incidence of 15‰, abortion is a common reproductive event in France. Thi s st... more Background: With an incidence of 15‰, abortion is a common reproductive event in France. Thi s study describes conditions of access to health care for abortions based on women's reports, taking into account the woman's background and the influence of the first professional contacted. Methods: A representative sample of 2,863 women, aged 18 to 44, was interviewed by telephone between September 2000 and January 2001. Of these women, 480 had an abortion in the last 10 years. Main results: The choice of first professional depended on women's background, as we found differences according to age, educational level or past induced abortion. This choice affected subsequent access conditions, in terms of time delay or complexity of patterns of care to access abortion services. Women who first contacted a private gynaecologist, which is the most frequent situation in France, had more direct and shorter patterns of care. Conversely, general practitioners were associated with longer and more indirect patterns of care, especially when women were less well educated. Conclusion: This study reveals the heterogeneous nature of patterns of access to an abortion in France. It also raises questions concerning the training of general practitioners, who seem to be less well prepared to take charge of a request for an abortion than other professionals. Efforts must be made to better inform women and these professionals about the process required for abortions.
Population & Sociétés, 2014
La crise de la pilule en France : vers un nouveau modèle contraceptif ? Les pilules de 3e et 4e g... more La crise de la pilule en France : vers un nouveau modèle contraceptif ? Les pilules de 3e et 4e génération ont fait l'objet d'une controverse importante fin 2012-début 2013 à propos du risque de thrombose veineuse associé à leur utilisation. Quelles en ont été les conséquences sur la contraception en France ? Analysant l'enquête Fecond menée quelques mois après par l'Inserm et l'Ined, Nathalie Bajos, Mylène Rouzaud-Cornabas, Henri Panjo, Aline Bohet et Caroline Moreau ont examiné les évolutions récentes en matière de pratiques contraceptives et la contribution du débat médiatique à ces changements.
BMC public health, Jan 18, 2016
There is growing recognition that youth sexual health entails a broad range of physical, emotiona... more There is growing recognition that youth sexual health entails a broad range of physical, emotional and psychosocial responses to sexual interactions, yet little is known about sexual dysfunctions and well being in youth populations. This study explored sexual dysfunctions among youth and its associations with other domains of sexual health. Sexual dysfunctions were defined as: problems related to orgasm, pain during intercourse, lack of sexual desire or sexual pleasure. Data were drawn from the 2010 French national sexual and reproductive health survey comprising a random sample of 2309 respondents aged 15-24 years. The current analysis included 842 females and 642 males who had sexual intercourse in the last 12 months. Chi square tests were used to test for differences in sexual dysfunctions by sex and explore associations with other domains of sexual health. Half of females (48%) reported at least one sexual dysfunction versus 23% of males. However, over half (57%) of youth report...
Human reproduction (Oxford, England), 2015
What are the characteristics and circumstances of pregnancies men report as unintended in France?... more What are the characteristics and circumstances of pregnancies men report as unintended in France? Pregnancies reported as unintended were most prevalent among young men with insecure financial situations, less stable relationships and inconsistent use of contraception or false assumptions about their partner's use of contraception. Efforts to involve men in family planning have increased over the last decade; however, little is known about factors associated with men's pregnancy intentions and associated contraceptive behaviours. The data presented in this study were drawn from the nationally representative FECOND study, a population-based survey conducted in France in 2010. The sample comprised 8675 individuals (3373 men), aged 15-49 years, who responded to a telephone interview about socio-demographics and topics related to sexual and reproductive health. The total refusal rate was 20%. This study included 2997 men, of whom 664 reported 893 recent pregnancies (in the 5 yea...
PLoS ONE, 2014
Objective: The relation between levels of contraceptive use and the incidence of induced abortion... more Objective: The relation between levels of contraceptive use and the incidence of induced abortion remains a topic of heated debate. Many of the contradictions are likely due to the fact that abortion is the end point of a process that starts with sexual activity, contraceptive use (or non-use), followed by unwanted pregnancy, a decision to terminate, and access to abortion. Trends in abortion rates reflect changes in each step of this process, and opposing trends may cancel each other out. This paper aims to investigate the roles played by the dissemination of contraception and the evolving norms of motherhood on changes in abortion rates. Methods: Drawing data from six national probability surveys that explored contraception and pregnancy wantedness in France from 1978 through 2010, we used multivariate linear regression to explore the associations between trends in contraceptive rates and trends in (i) abortion rates, (ii) unwanted pregnancy rates, (iii) and unwanted birth rates, and to determine which of these 3 associations was strongest. Findings: The association between contraceptive rates and abortion rates over time was weaker than that between contraception rates and unwanted pregnancy rates (p = 0.003). Similarly, the association between contraceptive rates and unwanted birth rates over time was weaker than that between contraceptive rates and unwanted pregnancy rates (p = 0.000).
The Lancet Child & Adolescent Health
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2018
We aimed to explore partner agreement in unintended pregnancy decisions and to describe predictor... more We aimed to explore partner agreement in unintended pregnancy decisions and to describe predictors of female and male perceived agreement with their partner regarding the decision to continue or terminate the pregnancy. This is a secondary analysis of the FECOND study, a population-based probability telephone survey conducted in France in 2010 comprising 8645 respondents aged 15-49 years. Pregnancy data were reported by individuals (not couple-level data). For female- and male-reported unintended pregnancies, we used generalised estimation equation models to estimate the odds of a female-only (disagreement) versus a joint (agreement) decision to continue or terminate an unintended pregnancy. The decision to continue an unintended pregnancy was reported as joint in 82% of female- and 88% of male-reported pregnancies. Pregnancy continuation was more likely to be perceived as female-only versus a joint decision if men perceived initial pregnancy intention disagreement (adjusted odds ra...
PloS one, 2018
To assess knowledge, pregnancy attitudes and contraceptive practices in relation to the Zika viru... more To assess knowledge, pregnancy attitudes and contraceptive practices in relation to the Zika virus outbreak in Brazil. We interviewed 526 women 18 to 49 years old in primary health services in a Northeastern capital of Brazil, in 2016. They provided information about their knowledge of Zika transmission and health consequences, their receipt of counseling related to sexual and perinatal transmission of Zika, their pregnancy intentions and reassessment of contraceptive options in the context of the Zika virus outbreak. Awareness about Zika congenital syndrome was high, but knowledge about sexual transmission was low. Few women had changed pregnancy intentions or contraceptive practices in response to Zika. Pregnant women were more likely to access counseling about family planning, condom use and pregnancy postponement due to Zika virus than non-pregnant women, which may suggest that health system responses followed pregnancy occurrence. We observed missed opportunities for prevention...
Culture, health & sexuality, Jan 18, 2017
This analysis is based on data from the Global Early Adolescent Study, which aims to understand t... more This analysis is based on data from the Global Early Adolescent Study, which aims to understand the factors that predispose young people aged 10-14 years to positive or negative health trajectories. Specifically, interview transcripts from 202 adolescents and 191 parents across six diverse urban sites (Baltimore, Ghent, Nairobi, Ile Ife, Assuit and Shanghai) were analysed to compare the perceived risks associated with entering adolescence and how these risks differed by gender. Findings reveal that in all sites except Ghent, both young people and their parents perceived that girls face greater risks related to their sexual and reproductive health, and because of their sexual development, were perceived to require more protection. In contrast, when boys grow up, they and their parents recognised that their independence broadened, and parents felt that boys were strong enough to protect themselves. This has negative consequences as well, as boys were perceived to be more prone to risk...
International perspectives on sexual and reproductive health, Jun 1, 2017
The World Health Organization recommends that contraceptives be offered on the day of a uterine e... more The World Health Organization recommends that contraceptives be offered on the day of a uterine evacuation procedure (i.e., induced abortion or postabortion care for an incomplete abortion). Short-acting methods can be initiated on the day of the uterine evacuation, regardless of procedure type. Survey data from a facility-based sample of 479 Bangladeshi women aged 18-49 who did not intend to become pregnant in the four months following their uterine evacuation were used to examine women's choice of short-acting contraceptive methods (pill, condoms or injectable). Service delivery correlates of contraceptive choice were identified using sequential logistic regression models. Seventy-three percent of women chose a short-acting contraceptive method on the day of their uterine evacuation. The odds that a woman chose a short-acting method, rather than no method, were lower among those who had had a medication abortion (odds ratio, 0.1) or dilatation and curettage (0.3) than among th...
Journal of Adolescent Health
Journal of Adolescent Health
The European Journal of Contraception & Reproductive Health Care
Perceived discordance of fertility desires may be more common among couples with certain sociodem... more Perceived discordance of fertility desires may be more common among couples with certain sociodemographic characteristics and may lead to lower contraceptive use. Using nationally representative data from adults ages 15-49 in France in 2010, we analysed associations between sociodemographic characteristics, perceived discordance of fertility desires and contraceptive use with design-based logistic regression. Only 8% of participants perceived discordant fertility desires while 92% perceived concordance with partner fertility desire. Discordance varied by age and relationship duration and by the presence of children from previous relationships. Perceived discordance was not associated with use of a hormonal or highly effective method. Beyond own intentions, perception of a partner&#39;s fertility desires was associated with using a highly effective method among participants using any method. Engaging men and couples in family planning programmes may be important for achieving both partners&#39; desired fertility goals.
Human reproduction (Oxford, England), Aug 1, 2016
What factors and subgroups have propelled the recent increase in intrauterine device (IUD) use in... more What factors and subgroups have propelled the recent increase in intrauterine device (IUD) use in the USA? The increase in IUD use, from 1.8 to 9.5% in the USA between 2002 and 2012, was driven primarily by a marked uptake among parous women who intended to have more children. Recent data suggest an unprecedented increase in IUD use among women in the USA, yet less is known about how this increase has affected the overall proportion of women, at risk of unintended pregnancy, who are using contraception and which social and economic groups are involved. Data are drawn from the 2002 and 2011-2013 National Surveys of Family Growth. The surveys were based on cross-sectional, national samples of women of 15-44 years of age in the USA. Women responded to in-person interviews, which lasted an average of 80 min. The response rate was 80% in 2002 and 73% in 2011-2013. The sample included 7643 completed interviews in 2002 and 5601 interviews in 2011-2013. This study was limited to women at ri...
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Papers by caroline moreau