由于妊娠期恶性肿瘤相对较少见，有关避孕方法选择或分娩时进行绝育的信息相对有限。本研究的目的是检查患有妊娠期恶性肿瘤的孕妇在分娩时选择的长效可逆避孕方法或手术绝育措施的类型。本横断面研究查询了美国医疗费用与使用项目国家住院样本。研究人群为2017年1月至2020年12月在医院设置中进行的阴道分娩和剖腹产。与没有恶性肿瘤的孕妇（n = 14,265,319）相比，具有乳腺癌（n = 1605）、白血病（n = 1190）、淋巴瘤（n = 1120）、甲状腺癌（n = 715）、宫颈癌（n = 425）和黑色素瘤（n = 400）的孕妇进行了比较。主要结果指标为在分娩期间住院期间使用长效可逆避孕方法（皮下植入物或宫内节育器）以及进行永久手术绝育（双侧输卵管结扎或双侧输卵管切除）的情况，由多项式回归模型进行评估，控制了临床、妊娠和分娩特征。与没有恶性肿瘤的孕妇相比，患有乳腺癌的孕妇更有可能进行双侧输卵管切除（调整后的几率比[aOR]为2.30）或宫内节育器（aOR 1.91）；没有一个接受皮下植入物。患有白血病的孕妇更有可能选择皮下植入物（aOR 2.22），而淋巴瘤患者更有可能进行双侧输卵管切除（aOR 1.93）和双侧输卵管结扎（aOR 1.76）。患有甲状腺癌的孕妇更有可能进行双侧输卵管结扎（aOR 2.21），没有一个接受皮下植入物。宫颈癌组中没有患者选择长效可逆避孕，她们更有可能进行双侧输卵管切除（aOR 2.08）。黑色素瘤组没有人选择长效可逆避孕。在年龄<30岁的孕妇中，乳腺癌（aOR 3.01）、宫颈癌（aOR 2.26）或淋巴瘤（aOR 2.08）患者进行双侧输卵管切除的几率增加。年龄<30岁的患有黑色素瘤的孕妇进行双侧输卵管结扎的几率也增加（aOR 5.36）。这项在美国进行的全国性评估结果表明，在患有妊娠期恶性肿瘤的孕妇中，分娩时的首选避孕方法或绝育方式因恶性肿瘤类型而异。

Since malignancy during pregnancy is uncommon, information regarding contraception selection or sterilization at delivery is limited. The objective of this study was to examine the type of long-acting reversible contraception or surgical sterilization procedure chosen by pregnant patients with malignancy at delivery.This cross-sectional study queried the Healthcare Cost and Utilization Project's National Inpatient Sample in the USA. The study population was vaginal and cesarean deliveries in a hospital setting from January 2017 to December 2020. Pregnant patients with breast cancer (n = 1605), leukemia (n = 1190), lymphoma (n = 1120), thyroid cancer (n = 715), cervical cancer (n = 425) and melanoma (n = 400) were compared with 14 265 319 pregnant patients without malignancy. The main outcome measures were utilization of long-acting reversible contraception (subdermal implant or intrauterine device) and performance of permanent surgical sterilization (bilateral tubal ligation or bilateral salpingectomy) during the index hospital admission for delivery, assessed with a multinomial regression model controlling for clinical, pregnancy and delivery characteristics.When compared with pregnant patients without malignancy, pregnant patients with breast cancer were more likely to proceed with bilateral salpingectomy (adjusted odds ratio [aOR] 2.30) or intrauterine device (aOR 1.91); none received the subdermal implant. Pregnant patients with leukemia were more likely to choose a subdermal implant (aOR 2.22), whereas those with lymphoma were more likely to proceed with bilateral salpingectomy (aOR 1.93) and bilateral tubal ligation (aOR 1.76). Pregnant patients with thyroid cancer were more likely to proceed with bilateral tubal ligation (aOR 2.21) and none received the subdermal implant. No patients in the cervical cancer group selected long-acting reversible contraception, and they were more likely to proceed with bilateral salpingectomy (aOR 2.08). None in the melanoma group chose long-acting reversible contraception. Among pregnant patients aged <30, the odds of proceeding with bilateral salpingectomy were increased in patients with breast cancer (aOR 3.01), cervical cancer (aOR 2.26) or lymphoma (aOR 2.08). The odds of proceeding with bilateral tubal ligation in pregnant patients aged <30 with melanoma (aOR 5.36) was also increased.The results of this nationwide assessment in the United States suggest that among pregnant patients with malignancy, the preferred contraceptive option or method of sterilization at time of hospital delivery differs by malignancy type.© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).