Kohn Julia E, Lopez Priscilla M, Simons Hannah R
Planned Parenthood Federation of America, 434 West 33 Street, New York, NY, USA.
Contraception. 2015 Jun;91(6):470-3. doi: 10.1016/j.contraception.2015.02.006. Epub 2015 Feb 20.
As obesity may affect the efficacy of some contraceptives, we examined weight, body mass index (BMI) and prevalence of obesity among female contraceptive clients at 231 U.S. health centers. A secondary aim was to analyze differences in contraceptive method use by obesity status.
Cross-sectional study using de-identified electronic health record data from family planning centers. We analyzed contraceptive visits made by 147,336 females aged 15-44 years in 2013.
A total of 46.1% of clients had BMI ≥25. Mean body weight was 154.4 lb (S.D.=41.9); mean BMI was 26.1 (S.D.=6.6). A total of 40% had BMI ≥26, when levonorgestrel emergency contraception may become less effective. Obese clients had higher odds of using a tier 1 or tier 3 contraceptive method and had lower odds of using a tier 2 or hormonal method than non-obese clients.
About half of contraceptive clients would be categorized as overweight or obese. Contraceptive method choices differed by obesity status.
About half of contraceptive clients in this study population were overweight or obese. Contraceptive method choices differed by obesity status. All women - regardless of body size - should receive unbiased, evidence-based counseling on the full range of contraceptive options so that they can make informed choices.
由于肥胖可能影响某些避孕药具的效果，我们在美国231家健康中心对女性避孕药具使用者的体重、体重指数（BMI）和肥胖患病率进行了调查。次要目的是分析肥胖状况对避孕药具使用方法的差异。
采用来自计划生育中心的去识别化电子健康记录数据进行横断面研究。我们分析了2013年147336名年龄在15 - 44岁女性的避孕就诊情况。
共有46.1%的使用者BMI≥25。平均体重为154.4磅（标准差 = 41.9）；平均BMI为26.1（标准差 = 6.6）。共有40%的使用者BMI≥26，此时左炔诺孕酮紧急避孕可能效果不佳。肥胖使用者使用1级或3级避孕方法的几率较高，而使用2级或激素避孕方法的几率低于非肥胖使用者。
约一半的避孕药具使用者可归类为超重或肥胖。避孕方法的选择因肥胖状况而异。
本研究人群中约一半的避孕药具使用者超重或肥胖。避孕方法的选择因肥胖状况而异。所有女性——无论体型如何——都应接受关于所有避孕选择的公正、基于证据的咨询，以便她们能够做出明智的选择。
