Makerere University-Johns Hopkins University Research Collaboration, Kampala, Uganda.
Contraception. 2011 Nov;84(5):512-9. doi: 10.1016/j.contraception.2011.02.002. Epub 2011 Mar 23.
The effect of combined oral contraceptives (COCs) and depot-medroxyprogesterone acetate (DMPA) on the area of cervical ectopy is not well understood.
From 1996 to 1999, we recruited women not using hormonal contraception from two family planning centers in Baltimore, MD. Upon study entry and 3, 6 and 12 months after the initial visit, participants were interviewed and received visual cervical examinations with photography. Ectopy was measured from digitized photographs and was analyzed both continuously and categorically (small [≤0.48 cm(2)] vs. large [>0.48 cm(2)]).
Of 1003 enrolled women, 802 returned for at least one follow-up visit. At 12 months, the numbers of women using COCs, DMPA or no hormonal method at least 50% of the time since the prior visit were 230, 76 and 229, respectively. After multivariable adjustment, COC use (vs. no hormonal use) was associated with large area of ectopy (odds ratio [OR]: 1.8, 95% confidence interval [CI]: 1.0-3.3). No significant relationship was observed between DMPA and large area of ectopy (OR: 0.5, 95% CI: 0.2-1.3). The incidence of large area of ectopy by contraceptive exposure (COC, DMPA or no hormonal method) was 17.4 (CI: 11.8-24.6), 10.9 (CI: 4.4-22.4) and 4.6 (CI: 2.2-8.4) per 100 woman-years, respectively.
Use of COCs, but not DMPA, was associated with large area of cervical ectopy. Area of ectopy at baseline was the strongest predictor of area of ectopy at follow-up.
联合口服避孕药（COC）和 depot-甲羟孕酮（DMPA）对宫颈异位面积的影响尚不清楚。
1996 年至 1999 年，我们从马里兰州巴尔的摩的两个计划生育中心招募了未使用激素避孕的女性。在研究开始时以及首次就诊后 3、6 和 12 个月，参与者接受了访谈并接受了宫颈视觉检查和摄影。从数字化照片中测量异位，并连续和分类进行分析（小[≤0.48 cm(2)]与大[>0.48 cm(2)]）。
在 1003 名入组的女性中，802 名至少随访一次。在 12 个月时，在过去的就诊后至少 50%的时间使用 COC、DMPA 或无激素方法的女性数量分别为 230、76 和 229。经多变量调整后，COC 使用（与无激素使用相比）与大面积异位（比值比[OR]：1.8，95%置信区间[CI]：1.0-3.3）相关。DMPA 与大面积异位之间未观察到显著关系（OR：0.5，95%CI：0.2-1.3）。根据避孕暴露（COC、DMPA 或无激素方法），大面积异位的发生率分别为 17.4（CI：11.8-24.6）、10.9（CI：4.4-22.4）和 4.6（CI：2.2-8.4）每 100 名妇女年。
COC 的使用，而不是 DMPA，与宫颈异位面积大有关。基线异位面积是随访时异位面积的最强预测因素。
