Unintended pregnancies and use, misuse and discontinuation of oral contraceptives.
Unintended pregnancies and use, misuse and discontinuation of oral contraceptives.
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意外怀孕以及口服避孕药的使用、误用和停用。
DOI：
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发表时间：
1995
影响因子：
0.2
通讯作者：
S. Long
中科院分区：
文献类型：
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作者：
M. Rosenberg;M. Waugh;S. Long
意外怀孕是一个公认的发生在妇女使用口服避孕药（OC）的结果，用户和方法失败。然而，口服避孕药也通过另一种认识不足的途径影响意外怀孕的发生：不希望怀孕但因副作用或其他原因停止使用口服避孕药的妇女停止使用口服避孕药。许多这样的妇女没有立即更换新的避孕药具和/或采用不太可靠的避孕药具。对于美国每年开始服用口服避孕药的约370万妇女来说，这是一个特别重要的考虑因素，因为这一群体通常会出现副作用，并且停药率很高。使用决策树跟踪OC使用者队列超过一年，我们估计超过100万例意外怀孕与OC使用，误用或停用有关。其中，61%的人是停用口服避孕药的妇女，66.6%的人是没有立即用其他避孕药替代的妇女，33.3%的人是因为采用了不太可靠的避孕方法。在持续的OC使用者中，大多数人表现出良好的依从性，由于人数众多，导致24%的怀孕。持续的OC用户谁是穷人遵守者，虽然少得多，是负责15%，由于他们的高怀孕率。在美国，停止口服避孕药的妇女的意外怀孕约占每年350万意外怀孕的20%，产生近26亿美元的费用。（250字处删节）
Unintended pregnancies are a recognized occurrence among women using oral contraceptives (OCs) as a consequence of both user and method failure. However, OCs also influence the occurrence of unintended pregnancies through an additional, poorly recognized, route: cessation of OC use by women who do not wish to become pregnant but stop using OCs because of side effects or other reasons. Many such women fail to immediately substitute a new contraceptive and/or adopt a less reliable contraceptive. This is a particularly important consideration for the approximately 3.7 million women who begin taking OCs in the United States each year since this group commonly experiences side effects and has a high discontinuation rate. Using a decision tree to follow a cohort of OC users over one year, we estimate that over 1 million unintended pregnancies are related to OC use, misuse or discontinuation. The greatest proportion of these, 61%, occur in women who discontinue OCs; of these, 66.6% occur in women who fail to immediately substitute other contraceptives and 33.3% because of the adoption of less reliable contraceptive methods. Of continuing OC users, the majority, exhibiting good compliance, contribute 24% of pregnancies because of their large numbers. Continuing OC users who are poor compliers, though many fewer, are responsible for 15% due to their high pregnancy rate. Unintended pregnancies in women who discontinue OCs account for approximately 20% of the 3.5 million annual unintended pregnancies in the United States, incurring costs of nearly +2.6 billion.(ABSTRACT TRUNCATED AT 250 WORDS)