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Lo dose pills and heavy women-article abstractFrom: RModugno@aol.comWed Feb 11 16:35:51 2004
May 2002 Volume 99, Number 5, Part 1 Pages 820 - 827 Body Weight and Risk of Oral Contraceptive Failure Victoria L. Holt, PhD, MPH,a Kara L. Cushing-Haugen, MS,b and Janet R. Daling, PhDa Objective: To examine the hypothesis that higher body weight increases the risk of oral contraceptive (OC) failure. Methods: We conducted a retrospective cohort analysis of data from 755 randomly selected female enrollees of Group Health Cooperative of Puget Sound who completed an in-person interview and dietary questionnaire between 1990 and 1994 as control subjects for a case-control study of ovarian cysts. Among the 618 women who were OC ever-users, we used Cox proportional hazards regression models to estimate the relative risk (RR) of pregnancy while using OCs associated with body weight quartile. Results: During 2822 person-years of OC use, 106 confirmed pregnancies occurred (3.8 per 100 person-years of exposure). After controlling for parity, women in the highest body weight quartile (70.5 kg or more) had a significantly increased risk of OC failure (RR 1.6, 95% confidence interval [CI] 1.1, 2.4) compared with women of lower weight. Higher elevations of risk associated with the highest weight quartile were seen among very low-dose OC users (RR 4.5, 95% CI 1.4, 14.4) and low-dose OC users (RR 2.6, 95% CI 1.2, 5.9), controlling for parity, race, religion, and menstrual cycle regularity. Conclusion: Our findings suggest that body habitus may affect metabolism sufficiently to compromise contraceptive effectiveness. Consideration of a woman's weight may be an important element of OC prescription. aDepartment of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA bDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA This work was supported by National Institute of Child Health and Human De velopment grants HD-25959 and HD-34712. (Obstet Gynecol 2002:99:820-827. © 2002 by The American College of Obstetricians and Gynecologists.)
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