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美国避孕方法医学适用标准,2024 年版。

U.S. Medical Eligibility Criteria for Contraceptive Use, 2024.

机构信息

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.

出版信息

MMWR Recomm Rep. 2024 Aug 8;73(4):1-126. doi: 10.15585/mmwr.rr7304a1.

Abstract

The 2024 U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) comprises recommendations for the use of specific contraceptive methods by persons who have certain characteristics or medical conditions. These recommendations for health care providers were updated by CDC after review of the scientific evidence and a meeting with national experts in Atlanta, Georgia, during January 25-27, 2023. The information in this report replaces the 2016 U.S. MEC (CDC. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR 2016:65[No. RR-3]:1-103). Notable updates include 1) the addition of recommendations for persons with chronic kidney disease; 2) revisions to the recommendations for persons with certain characteristics or medical conditions (i.e., breastfeeding, postpartum, postabortion, obesity, surgery, deep venous thrombosis or pulmonary embolism with or without anticoagulant therapy, thrombophilia, superficial venous thrombosis, valvular heart disease, peripartum cardiomyopathy, systemic lupus erythematosus, high risk for HIV infection, cirrhosis, liver tumor, sickle cell disease, solid organ transplantation, and drug interactions with antiretrovirals used for prevention or treatment of HIV infection); and 3) inclusion of new contraceptive methods, including new doses or formulations of combined oral contraceptives, contraceptive patches, vaginal rings, progestin-only pills, levonorgestrel intrauterine devices, and vaginal pH modulator. The recommendations in this report are intended to serve as a source of evidence-based clinical practice guidance for health care providers. The goals of these recommendations are to remove unnecessary medical barriers to accessing and using contraception and to support the provision of person-centered contraceptive counseling and services in a noncoercive manner. Health care providers should always consider the individual clinical circumstances of each person seeking contraceptive services. This report is not intended to be a substitute for professional medical advice for individual patients; when needed, patients should seek advice from their health care providers about contraceptive use.

摘要

2024 年美国避孕方法医学标准(U.S. MEC)包括了对具有某些特征或医疗状况的人群使用特定避孕方法的建议。这些针对医疗保健提供者的建议是由疾病预防控制中心在对科学证据进行审查以及 2023 年 1 月 25 日至 27 日在佐治亚州亚特兰大与全国专家举行会议后进行更新的。本报告中的信息取代了 2016 年美国 MEC(疾病预防控制中心。美国避孕方法医学标准,2016 年。MMWR 2016:65[No. RR-3]:1-103)。值得注意的更新包括 1)为慢性肾脏病患者添加了建议;2)对具有某些特征或医疗状况的人群的建议进行了修订(即母乳喂养、产后、流产后、肥胖、手术、深静脉血栓形成或肺栓塞伴或不伴抗凝治疗、血栓形成倾向、浅静脉血栓形成、心脏瓣膜病、围产期心肌病、系统性红斑狼疮、HIV 感染高风险、肝硬化、肝肿瘤、镰状细胞病、实体器官移植以及抗逆转录病毒药物与用于预防或治疗 HIV 感染的药物相互作用);3)纳入了新的避孕方法,包括复方口服避孕药、避孕贴剂、阴道环、单纯孕激素避孕药、左炔诺孕酮宫内节育器和阴道 pH 调节剂的新剂量或配方。本报告中的建议旨在为医疗保健提供者提供循证临床实践指南。这些建议的目的是消除获得和使用避孕措施的不必要的医疗障碍,并以非强制的方式支持提供以个人为中心的避孕咨询和服务。医疗保健提供者应始终考虑寻求避孕服务的每个人的个体临床情况。本报告无意替代针对个别患者的专业医疗建议;如有需要,患者应向其医疗保健提供者咨询避孕问题。

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