怀孕前使用避孕药和流产:前性队列研究.
Jennifer J Yland1, Amelia K Wesselink1, Sonia Hernandez-Diaz2
1Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
BMJ medicine
|September 14, 2023
概括
怀孕前使用避孕药一般不会增加流产风险. 然而,最近使用贴片或注射避孕药可能与更高的流产率有关,尽管需要进一步的研究.
科学领域:
- 生殖健康 生殖健康
- 产科和妇科 产科和妇科
- 临床流行病学临床流行病学
背景情况:
- 流产是一种常见的妊娠并发症.
- 了解影响流产的因素对于生殖健康至关重要.
- 预孕前的避孕方法对早期怀孕结果的影响需要研究.
研究的目的:
- 评估各种预孕避孕方法与流产风险之间的关联.
- 为了确定在怀孕前使用特定的荷尔蒙或非荷尔蒙避孕药是否会影响流产.
主要方法:
- 一项前性队列研究,涉及13,460名参与者,年龄在21至45岁之间,计划在美国和加拿大怀孕.
- 收集关于避孕史,预孕行为和早期怀孕结果 (包括流产) 的数据.
- 在不同类别的近期使用的孕前避孕药与屏障方法之间比较流产率.
主要成果:
- 大多数预孕避孕方法 (口服避孕药,宫内节育器,戒指,植入物,自然方法) 与屏障方法相比没有显著的流产相关性.
- 最近使用避孕贴或注射避孕药与较高的流产率 (IRR分别为1.34和1.44) 相比,与屏障方法相关.
- 对于贴片和注射避孕药的这些发现是基于参与者数量较少的,导致不准确的估计和潜在的残留混.
结论:
- 最常见的避孕方法的使用与流产风险增加无关.
- 最近使用贴片或注射避孕药与更高的流产率之间存在潜在的,尽管不精确的联系.
- 需要使用更大的样本大小进行进一步的研究,以确认或驳斥贴片/注射避孕药与流产之间的关联,考虑到潜在的混因素.
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