Hirvonen E, Idänpään-Heikkilä J
University of Helsinki, Finland.
Am J Obstet Gynecol. 1990 Jul;163(1 Pt 2):281-4. doi: 10.1016/0002-9378(90)90568-r.
From 1975 to 1984, there were 1,585,000 women-years of oral contraceptive use and 1,975,000 women-years of copper-bearing intrauterine device use in Finland. During this 10-year period, 20 women between 15 and 39 years of age died of pulmonary embolism, 41 of coronary heart disease, and 311 of intracranial hemorrhage. The diagnoses were confirmed in 89% at necropsy examination. The contraceptive method used by patients was determined in 84% by means of inquiry sent to family planning clinics. Among the 20 patients who died of pulmonary embolism, four died while taking the pill, which gives a relative risk of 1.2 (95% confidence limits, 0.37 to 3.62; p = 0.78). The corresponding values for death from myocardial infarction and intracranial hemorrhage were 0.19 (95% confidence limits, 0.05 to 0.70; p = 0.01) and 0.36 (95% confidence limits, 0.18 to 0.70; p = 0.03), respectively. None among the copper intrauterine device users under the age of 40 years died of pulmonary embolism during 1,383,000 women-years of intrauterine device use. The relative risk of death from intracranial hemorrhage among intrauterine device users was 1.18 (95% confidence limits, 0.70 to 1.99, p = 0.25).
1975年至1984年期间，芬兰有158.5万妇女年使用口服避孕药，197.5万妇女年使用含铜宫内节育器。在这10年期间，15至39岁的20名妇女死于肺栓塞，41名死于冠心病，311名死于颅内出血。尸检检查确诊了89%的诊断。通过向计划生育诊所发送询问，84%的患者确定了所使用的避孕方法。在20名死于肺栓塞的患者中，4名在服用避孕药时死亡，相对风险为1.2（95%置信区间，0.37至3.62；p = 0.78）。心肌梗死和颅内出血死亡的相应值分别为0.19（95%置信区间，0.05至0.70；p = 0.01）和0.36（95%置信区间，0.18至0.70；p = 0.03）。在138.3万妇女年的宫内节育器使用期间，40岁以下的含铜宫内节育器使用者中无人死于肺栓塞。宫内节育器使用者颅内出血死亡的相对风险为1.18（95%置信区间，0.70至1.99，p = 0.25）。
