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口服避孕药的使用:与住院频率及慢性病风险指标的关联

Oral contraceptive use: association with frequency of hospitalization and chronic disease risk indicators.

作者信息

Hoover R, Bain C, Cole P, MacMahon B

出版信息

Am J Public Health. 1978 Apr;68(4):335-41. doi: 10.2105/ajph.68.4.335.

Abstract

A questionnaire was mailed to 97,364 married women, aged 26--50, resident in Greater Boston in 1970, requesting information on lifetime oral contraceptive (OC) use, reproductive history, education, and hospitalization experience in 1969; 65,843 women responded. In 1973 a second questionnaire was mailed to 37,292 of these women, including all OC users and an equal number of non-users matched on age, parity, education, and town of residence. This questionnaire related to use of OCs, other female hormones, and the menopause. OC use was most strongly related to age, with a sixfold increase in use from the oldest women (of whom 10 per cent had used OCs at some time) to the youngest. Use was directly related to education and mobility and inversely related to parity. Reasons for beginning and ceasing use differed for women of different ages and educational attainment. Thus, use of OCs varies with social and reproductive characteristics that are risk indicators for many diseases. OC use was associated with increased risk of hospitalization for thromboembolic disease (risk ratio = 1.5, 95 per cent confidence limits 1.2, 3.2) and for mental illness, hyperthyroidism, hypertension, and cancer of the cervix. OC users were hospitalized for many non-life threatening conditions 20 to 40 per cent more frequently than were non-users.

摘要

1970年,一份调查问卷被邮寄给居住在大波士顿地区、年龄在26至50岁之间的97364名已婚女性,询问她们1969年的口服避孕药(OC)使用情况、生育史、教育程度和住院经历;65843名女性进行了回复。1973年,第二份调查问卷被邮寄给其中37292名女性,包括所有口服避孕药使用者以及同等数量在年龄、胎次、教育程度和居住城镇方面相匹配的非使用者。这份问卷涉及口服避孕药、其他女性激素以及更年期的使用情况。口服避孕药的使用与年龄最为密切相关,从年龄最大的女性(其中10%曾在某个时候使用过口服避孕药)到最年轻的女性,使用率增加了六倍。使用率与教育程度和流动性呈正相关,与胎次呈负相关。不同年龄和教育程度的女性开始和停止使用口服避孕药的原因有所不同。因此,口服避孕药的使用因社会和生殖特征而异,而这些特征是许多疾病的风险指标。口服避孕药的使用与血栓栓塞性疾病住院风险增加相关(风险比=1.5,95%置信区间1.2,3.2),与精神疾病、甲状腺功能亢进、高血压和宫颈癌住院风险增加也相关。口服避孕药使用者因许多非危及生命的疾病住院的频率比非使用者高20%至40%。

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