Contraceptive Failure in the United States: Estimates from the 2006-2010 National Survey of Family Growth.
Contraceptive Failure in the United States: Estimates from the 2006-2010 National Survey of Family Growth.
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DOI：
10.1363/psrh.12017
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发表时间：
2017-03
影响因子：
5.8
通讯作者：
Trussell J
中科院分区：
文献类型：
--
作者：
Sundaram A;Vaughan B;Kost K;Bankole A;Finer L;Singh S;Trussell J
避孕失败率衡量的是女性在使用避孕药时怀孕的可能性。有关这些比率的信息使夫妇能够在知情的情况下做出避孕选择。失败率上一次是在2002年估计的，此后发生的社会和经济变化需要重新估计。为了估计美国最常用的可逆方法的失败率，使用了2006-2010年全国家庭增长调查的数据；分析了6683名女性提供的约15,728次避孕用法间隔。古特马赫研究所2008年堕胎患者调查的数据被用来调整堕胎漏报的情况。使用Kaplan-Meier方法通过使用年限估计相关的单次递减失效概率。失败率与1995年和2002年的失败率进行了比较。在所有方法中，长效可逆避孕药(宫内节育器和植入物)的失败率最低(1%)，而避孕套和停用避孕套的失败率最高(分别为13%和20%)。然而，自1995年以来，避孕套的失败率显著下降(从18%)，所有激素方法的失败率加在一起也是如此(从8%降至6%)。所有可逆方法的失败率从2002年的12%下降到2006-2010年的10%。这些失败率的广泛下降扭转了变化极小的长期模式。未来的研究应该探索这些趋势背后的原因，以及进一步改进的可能性。
Contraceptive failure rates measure a woman's probability of becoming pregnant while using a contraceptive. Information about these rates enables couples to make informed contraceptive choices. Failure rates were last estimated for 2002, and social and economic changes that have occurred since then necessitate a reestimation. To estimate failure rates for the most commonly used reversible methods in the United States, data from the 2006–2010 National Survey of Family Growth were used; some 15,728 contraceptive use intervals, contributed by 6,683 women, were analyzed. Data from the Guttmacher Institute's 2008 Abortion Patient Survey were used to adjust for abortion underreporting. Kaplan‐Meier methods were used to estimate the associated single‐decrement probability of failure by duration of use. Failure rates were compared with those from 1995 and 2002. Long‐acting reversible contraceptives (the IUD and the implant) had the lowest failure rates of all methods (1%), while condoms and withdrawal carried the highest probabilities of failure (13% and 20%, respectively). However, the failure rate for the condom had declined significantly since 1995 (from 18%), as had the failure rate for all hormonal methods combined (from 8% to 6%). The failure rate for all reversible methods combined declined from 12% in 2002 to 10% in 2006–2010. These broad‐based declines in failure rates reverse a long‐term pattern of minimal change. Future research should explore what lies behind these trends, as well as possibilities for further improvements.