WEIGHT, OBESITY AND ORAL CONTRACEPTIVE FAILURE

描述：（改编自研究者摘要） 安全有效的节育对大多数年轻妇女至关重要， 超过一半使用可逆避孕的美国女性是口服避孕药。 避孕药（OC）使用者。 虽然业主立案法团的理论失败率最低 为计划生育的妇女建议的任何可逆方法的比率 生育（每年0.2%），实际OC失败率为10至15倍 更高，导致美国OC用户中有50万人意外怀孕 每年。 这种差异并没有导致很多流行病学研究 OC失败的风险因素，因为大多数失败被认为是由于 患者误用（用户故障）。 然而，OC剂量未滴定至患者 体重，初步研究表明，体型可能有一个 对OC失败的可能性产生巨大影响。 因此 研究人员提出了一项基于人群的病例对照研究， 参加保健组织的育龄妇女， 华盛顿西部的一个州，以测试肥胖可能会增加的假设， 口服避孕药失败的风险，同时考虑使用者和方法 失败 OC失败与其他因素之间的关系可能 影响OC代谢和雌激素产生（吸烟，运动， 药物、饮食）也将进行研究。 潜在病例将是 普吉特海湾团体保健合作社的所有18-39岁注册者 (GHC)同时妊娠试验阳性的OC使用者， 1997年9月1日和2000年8月31日，使用计算机化药房选择 和实验室记录，并通过病历验证合格性 抽象（n=600）。 对照组为相同数量的非妊娠OC 用户，从计算机化药房文件和频率中随机选择 与年龄、初级保健诊所地区和OC使用持续时间的病例相匹配。 将通过面对面访谈从病例和对照中获得数据， 饮食调查表，并与GHC计算机药房 数据库 将对受试者进行访谈，以了解 OC使用（例如，跳过或不规则定时给药）和体型详情 （身高，体重，体重增加模式），人体测量将 获得，以及OC失败的其他风险因素，如慢性疾病， 药物使用和疾病将被评估。

DESCRIPTION: (Adapted from Investigator's Abstract) The availability of safe and effective birth control is of vital importance to most young women, and over half of U.S. women who use reversible contraception are oral contraceptive (OC) users. While OCs have the lowest theoretical failure rates of any reversible method recommended for women planning future childbearing (0.2% per year), actual OC failure rates are 10 to 15 times higher, resulting in 500,000 unintended pregnancies among U.S. OC users annually. This discrepancy has not resulted in much epidemiologic research into risk factors for OC failure, as most failures are assumed to be due to patient misuse (user failure). However, OC dose is not titrated to patient weight, and preliminary research indicates that body habitus may have a dramatic impact on the likelihood of OC failure. Consequently, the investigators propose a population-based case-control study among reproductive-age women enrolled in a health maintenance organization in western Washington State to test the hypothesis that obesity may increase risk of oral contraceptive failure, taking into account both user and method failure. The associations between OC failure and other factors potentially affecting OC metabolism and estrogen production (smoking, exercise, medications, diet) will be investigated as well. Potential cases will be all 18-39 year old enrollees of Group Health Cooperative of Puget Sound (GHC) who are OC users with a concurrent positive pregnancy test between September 1, 1997 and August 31, 2000, selected using computerized pharmacy and laboratory records with eligibility verified by medical record abstraction (n=600). Controls will be an equal number of non-pregnant OC users, randomly selected from computerized pharmacy files and frequency matched to cases on age, primary care clinic region, and OC use duration. Data will be obtained from cases and controls by in-person interview and dietary questionnaire, and linked with the GHC computerized pharmacy database. Subjects will be interviewed regarding patterns of regularity of OC use (e.g., skipped or irregularly timed doses) and body habitus details (height, weight, weight gain patterns), anthropometric measurements will be obtained, and other risk factors for OC failure such as chronic disease, medication use, and illness will be assessed.