Contraceptive failure rates in France: results from a population-based survey
Contraceptive failure rates in France: results from a population-based survey
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DOI：
10.1093/humrep/dem184
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发表时间：
2007-09-01
影响因子：
6.1
通讯作者：
Bouyer, J.
中科院分区：
文献类型：
--
作者：
Moreau, C.;Trussell, J.;Bouyer, J.
背景技术背景：尽管法国广泛使用高效的避孕方法，但每三次怀孕中就有一次是意外怀孕，其中65%是在使用避孕药具时发生的。在美国，49%的怀孕是意外的，其中一半是由于避孕失败。这项研究提供了法国妇女的方法特定的失败率的估计。方法：我们使用的数据来自2000年Cocon研究，这是一个以人群为基础的队列研究，包括1689名年龄在18-44岁的妇女，她们描述了自己的避孕史。分段常数风险模型用于估计避孕方法使用的前5年内的避孕失败率。引入随机效应是为了考虑到一些妇女的贡献超过避孕发作的事实。这些相同的模型用于评估社会人口特征对避孕药、宫内节育器（IUD）和避孕套使用者避孕失败概率的影响。结果：总体而言，2.9%的妇女在使用的第一年和8.4%的前5年使用避孕失败。宫内节育器的第一年失败率最低（1.1%），其次是避孕药（2.4%）、避孕套（3.6%）、生育意识方法（定期禁欲或根据温度确定安全期）（7.7%）、戒断（10.1%）和杀精剂（21.7%）。这些故障率随用户特征变化不大。结论：与美国妇女相比，法国妇女的失败率较低，这表明需要进一步探讨避孕措施的差异。
BACKGROUND: Despite the widespread use of highly effective contraceptive methods in France, one in every three pregnancies is unintended, of which 65% occur while using contraceptives. In the USA, 49% of pregnancies are unintended, half of which result from contraceptive failure. This study provides estimates of method-specific failure rates among French women. METHODS: We use data from the 2000 Cocon Study, a population-based cohort, comprising a representative sample of 1689 women aged 18-44 years who described their contraceptive history. Piecewise-constant hazards models were used to estimate method-specific contraceptive failure rates during the first 5 years of contraceptive use. A random effect was introduced to take into account the fact that some women contribute more than I contraceptive episode. These same models were used to assess the effects of socio-demographic characteristics on the probability of contraceptive failure among pill, intrauterine device (IUD) and condom users. RESULTS: Overall, 2.9% of women experienced a contraceptive failure in the first year of use and 8.4% in the first 5 years of use. The IUD had the lowest first year failure rate (1.1%), followed by the pill (2.4%), the condom (3.6%), fertility awareness methods (periodic abstinence or safe period by temperature) (7.7%), withdrawal (10.1%) and spermicides (21.7%). These failure rates varied little by user characteristics. CONCLUSIONS: Lower failure rates among French women compared with those reported for US women suggest differences in contraceptive practices which need to be further explored.