Effects of Oral Contraceptive Use on Anterior Cruciate Ligament Injury Epidemiology
Effects of Oral Contraceptive Use on Anterior Cruciate Ligament Injury Epidemiology
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DOI：
10.1249/mss.0000000000000806
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发表时间：
2016-04-01
期刊：
影响因子：
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通讯作者：
Baillargeon, Jacques G.
中科院分区：
文献类型：
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作者：
Gray, Aaron M.;Gugala, Zbigniew;Baillargeon, Jacques G.
前言/目的前交叉韧带损伤经常给运动员带来严重的后果。雌激素水平升高可能会增加受伤的风险。口服避孕药可部分或完全减轻这种风险。本研究的目的是确定接受前交叉韧带手术重建的妇女是否比匹配的未受伤人群更不可能使用口服避孕药。方法采用2002 - 2012年全国保险理赔数据进行病例对照研究。参与者包括15-39岁的女性。病例定义为2002年至2012年间接受前十字韧带手术重建的患者。对照组与病例的比例为3/1。暴露于口服避孕药被定义为在索引日期之前的12个月内存在任何口服避孕药处方。使用条件多变量logistic回归来估计口服避孕药使用的校正优势比。结果15-19岁接受前交叉韧带手术修复的女性使用口服避孕药的可能性比匹配对照组低18%（校正优势比0.82;95% CI, 0.75-0.91; P < 0.0001）。25-29岁和30-34岁两个较大年龄组的病例比对照组更有可能使用口服避孕药，校正比值比分别为1.15 （95% CI, 1.02-1.30, P < 0.05）和1.16 （95% CI, 1.04-1.31, P < 0.05）。结论口服避孕药可降低年轻女性前交叉韧带损伤风险。尽管有报道称运动员更容易发生前交叉韧带损伤，口服避孕药的使用率是非运动员的两倍，但这些数据表明，15-19岁接受前交叉韧带重建的女性口服避孕药的使用率低于一般人群。
Introduction/PurposeAnterior cruciate ligament injuries often incur major consequences for athletes. Elevated estrogen levels are likely increase the risk for injury. This risk may be partially or fully mitigated by the use of oral contraceptives. The purpose of this study was to determine if women undergoing anterior cruciate ligament surgical reconstruction were less likely to use oral contraceptives than matched noninjured population.MethodsThis is a case-control study utilizing national insurance claims data from 2002 TO 2012. Participants included women age 15-39 yr. Cases were defined as those receiving surgical reconstruction of the anterior cruciate ligament between 2002 and 2012. Controls were matched 3/1 to cases. Exposure to oral contraceptives was defined as the presence of any prescription fill for oral contraceptives during the previous 12 months to index date. Conditional multivariate logistic regression was used to estimate adjusted odds ratios for the use of oral contraceptives.ResultsWomen age 15-19 yr undergoing surgical repair of the anterior cruciate ligament were 18% less likely to use oral contraceptives than matched controls (adjusted odds ratio, 0.82; 95% CI, 0.75-0.91; P < 0.0001). Cases among two older age groups, 25-29 and 30-34 yr, were more likely to use oral contraceptives than controls with adjusted odds ratios of 1.15 (95% CI, 1.02-1.30; P < 0.05) and 1.16 (95% CI, 1.04-1.31; P < 0.05), respectively.ConclusionsThe use of oral contraceptives potentially modifies anterior cruciate ligament injury risk in young women. Despite reports that athletes, who are more prone to anterior cruciate ligament injury, use oral contraceptives at about twice the rate of nonathletes, these data suggest that women ages 15-19 yr undergoing anterior cruciate ligament reconstruction used oral contraceptives at a lower rate than the general population.