Getu Fasil, Tesfaye Addisu, Mekuria Surafel, Ayehubizu Liyew Mekonen, Tahir Bawlah, Roble Abdurahman Kedir, Getu Eyob, Walle Muluken
Department of Medical Laboratory Science, Institute of Health Science, Jigjiga University, Jigjiga, Ethiopia.
Department of Public Health, Institute of Health Science, Jigjiga University, Jigjiga, Ethiopia.
Open Access J Contracept. 2025 Sep 4;16:97-110. doi: 10.2147/OAJC.S544527. eCollection 2025.
Combined Oral Contraceptives are associated with enhanced procoagulant effects, decreased anticoagulant effects, and equivocal effects on fibrinolysis. The main aim of this study was to compare the mean value of platelet count, PT, and APTT among COC users and non-users and to determine factors associated with coagulopathy among COC users attending Family Guidance Association (FGAE), Jigjiga Medium clinic, Eastern Ethiopia.
A comparative cross-sectional study was conducted at the FGAE, Jigjiga Medium clinic. A total of 393 women were enrolled using a systematic random sampling method. Socio-demographic and clinical data were obtained via face-to-face interviews and extracted from the medical chart, respectively. To determine PT, APTT, and platelet count, 6.7 milliliters of venous blood was collected. The data were entered into Epi Info version 7.2.4.0 and then transferred to SPSS version 20 for analysis. The Shapiro-Wilk test was used to examine the distribution of the data. Data comparisons between the two groups were conducted using an independent -test and the Mann-Whitney -test. To determine factors associated with coagulopathy among COC users, Bivariable and multivariable logistic regression analyses were employed. P-values below 0.05 were regarded as statistically significant.
A sum of 393 subjects (131 COC users and 262 age-matched non-COC-user women) were enrolled in this study. The mean age was 27.67±4.14 (28.12±4.49 years old for COC users and 27.45±3.94 years old for non-COC users. The mean difference indicated that PT and APTT were lower by -1.14 (-1.36,-0.92) and -2.48 (-3.04, -1.91), respectively, in COC user women compared to non-COC users. However, platelet count was significantly elevated in the COC users group (P-value <0.001). The mean ±SD values were 259.5±79.00 and 191.1±27.98 in COC users and non-COC users, respectively. The overall prevalence of coagulopathy was 38.9% (51/131): from this abnormality, 40.5% (53/131) of the COC users showed shortened PT, and 27.5% (36/131) showed shortened APTT. Long-term use of COC (>5 years) was significantly associated with Coagulopathy (AOR = 0.035; 95% CI: 0.004-0.343).
This study showed that COC users exhibited a greater tendency toward hypercoagulability, placing these women at an increased risk of thromboembolic effects compared to COC non-users. There is a high prevalence of coagulopathy among COC users, and long-term usage of COC can lead to hypercoagulation and thrombotic abnormalities.
复方口服避孕药与促凝血作用增强、抗凝作用降低以及对纤维蛋白溶解的影响不明确有关。本研究的主要目的是比较复方口服避孕药使用者和非使用者的血小板计数、凝血酶原时间（PT）和活化部分凝血活酶时间（APTT）的平均值，并确定在埃塞俄比亚东部吉吉加中等诊所就诊的复方口服避孕药使用者中与凝血病相关的因素。
在吉吉加中等诊所的家庭指导协会（FGAE）进行了一项比较性横断面研究。采用系统随机抽样方法共纳入393名女性。社会人口学和临床数据分别通过面对面访谈获得并从病历中提取。为测定PT、APTT和血小板计数，采集6.7毫升静脉血。数据录入Epi Info 7.2.4.0版本，然后转移到SPSS 20版本进行分析。采用夏皮罗-威尔克检验来检验数据的分布。两组之间的数据比较采用独立t检验和曼-惠特尼U检验。为确定复方口服避孕药使用者中与凝血病相关的因素，采用双变量和多变量逻辑回归分析。P值低于0.05被视为具有统计学意义。
本研究共纳入393名受试者（131名复方口服避孕药使用者和262名年龄匹配的非复方口服避孕药使用者女性）。平均年龄为27.67±4.14岁（复方口服避孕药使用者为28.12±4.49岁，非复方口服避孕药使用者为27.45±3.94岁）。平均差异表明，与非复方口服避孕药使用者相比，复方口服避孕药使用者女性的PT和APTT分别降低了-1.14（-1.36，-0.92）和-2.48（-3.04，-1.91）。然而，复方口服避孕药使用者组的血小板计数显著升高（P值<0.001）。复方口服避孕药使用者和非使用者的平均值±标准差分别为259.5±79.00和191.1±27.98。凝血病的总体患病率为38.9%（51/131）：在这种异常情况中，40.5%（53/131）的复方口服避孕药使用者PT缩短，27.5%（36/131）的使用者APTT缩短。长期使用复方口服避孕药（>5年）与凝血病显著相关（比值比=0.035；95%置信区间：0.004-0.343）。
本研究表明，与非复方口服避孕药使用者相比，复方口服避孕药使用者表现出更高的高凝倾向，使这些女性发生血栓栓塞效应的风险增加。复方口服避孕药使用者中凝血病的患病率很高，长期使用复方口服避孕药可导致高凝和血栓形成异常。
