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Association between levonorgestrel emergency contraception and the risk of ectopic pregnancy: a multicenter case-control study.

Zhang J, Li C, Zhao WH, Xi X, Cao SJ, Ping H, Qin GJ, Cheng L, Huang HF - Sci Rep (2015)

Bottom Line: Compared to women who did not use contraceptives, current use of LNG-EC reduced the risk for intrauterine pregnancy (Adjusted OR [AOR] = 0.20, 95%CI: 0.14-0.27), but did not increase the risk for EP (AOR2 = 1.04, 95%CI: 0.76-1.42).Furthermore, compared to women who did not have further act of intercourse, women with unprotected further act of intercourse were at a higher risk of EP (AOR1 = 2.35, 95%CI: 1.17-4.71), and women with repeated use of LNG-EC for further intercourse during the same cycle was also associated with a higher risk for EP (AOR1 = 3.08, 95%CI: 1.09-8.71; AOR2 = 2.49, 95%CI: 1.00-6.19).A better understanding of the risk of EP following LNG-EC failure can optimize LNG-EC use and thus reduce the risk of EP.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200030, China.

ABSTRACT
Cases of ectopic pregnancy (EP) following levonorgestrel emergency contraception (LNG-EC) failure have been reported continuously, but whether there is an association between EP risk and LNG-EC is unclear. We concluded a case-control study to explore this association by recruiting 2,411 EP patients as case group, and 2,416 women with intrauterine pregnancy and 2,419 non-pregnant women as control groups. Odds ratios (ORs) and their 95% confidential intervals (CIs) were calculated and adjusted for potential confounding factors. Previous use of LNG-EC was not correlated with the EP. Compared to women who did not use contraceptives, current use of LNG-EC reduced the risk for intrauterine pregnancy (Adjusted OR [AOR] = 0.20, 95%CI: 0.14-0.27), but did not increase the risk for EP (AOR2 = 1.04, 95%CI: 0.76-1.42). Furthermore, compared to women who did not have further act of intercourse, women with unprotected further act of intercourse were at a higher risk of EP (AOR1 = 2.35, 95%CI: 1.17-4.71), and women with repeated use of LNG-EC for further intercourse during the same cycle was also associated with a higher risk for EP (AOR1 = 3.08, 95%CI: 1.09-8.71; AOR2 = 2.49, 95%CI: 1.00-6.19). A better understanding of the risk of EP following LNG-EC failure can optimize LNG-EC use and thus reduce the risk of EP.

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Related in: MedlinePlus

The definition of previous cycle and current cycle.
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f2: The definition of previous cycle and current cycle.

Mentions: The definitions of previous contraceptive user and current contraceptive user have been described previously41. Previous cycle is defined as the menstrual cycle before the LMP for EP and IUP women, and the one before the previous menstrual period (PMP) for non-pregnant women. Current cycle refers to the menstrual cycle after LMP for EP and IUP women, and the one between PMP and LMP for non-pregnant women (Figure 2). A woman who had used a long-term contraceptive method including IUDs or OCPs for at least one menstrual cycle or who had used a short-term contraceptive method including ECPs or condoms at least once was considered as a user of a given method. “Previous user of contraceptives” was defined as a woman who had used any contraceptive in the previous cycle, and “current user of contraceptive” was defined as a woman who used a given contraceptive method in the current cycle. A woman who had undergone tubal sterilization was considered as a current user, and a woman who had undergone reversal of tubal sterilization was considered as a previous user. A woman was considered as a previous IUDs user if she had inserted an IUDs but later removed it, while a current user referred to a woman who was using an IUDs during the interview. Current non-users of contraception referred to women who did not use any contraceptive methods in the current cycle.


Association between levonorgestrel emergency contraception and the risk of ectopic pregnancy: a multicenter case-control study.

Zhang J, Li C, Zhao WH, Xi X, Cao SJ, Ping H, Qin GJ, Cheng L, Huang HF - Sci Rep (2015)

The definition of previous cycle and current cycle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325579&req=5

f2: The definition of previous cycle and current cycle.
Mentions: The definitions of previous contraceptive user and current contraceptive user have been described previously41. Previous cycle is defined as the menstrual cycle before the LMP for EP and IUP women, and the one before the previous menstrual period (PMP) for non-pregnant women. Current cycle refers to the menstrual cycle after LMP for EP and IUP women, and the one between PMP and LMP for non-pregnant women (Figure 2). A woman who had used a long-term contraceptive method including IUDs or OCPs for at least one menstrual cycle or who had used a short-term contraceptive method including ECPs or condoms at least once was considered as a user of a given method. “Previous user of contraceptives” was defined as a woman who had used any contraceptive in the previous cycle, and “current user of contraceptive” was defined as a woman who used a given contraceptive method in the current cycle. A woman who had undergone tubal sterilization was considered as a current user, and a woman who had undergone reversal of tubal sterilization was considered as a previous user. A woman was considered as a previous IUDs user if she had inserted an IUDs but later removed it, while a current user referred to a woman who was using an IUDs during the interview. Current non-users of contraception referred to women who did not use any contraceptive methods in the current cycle.

Bottom Line: Compared to women who did not use contraceptives, current use of LNG-EC reduced the risk for intrauterine pregnancy (Adjusted OR [AOR] = 0.20, 95%CI: 0.14-0.27), but did not increase the risk for EP (AOR2 = 1.04, 95%CI: 0.76-1.42).Furthermore, compared to women who did not have further act of intercourse, women with unprotected further act of intercourse were at a higher risk of EP (AOR1 = 2.35, 95%CI: 1.17-4.71), and women with repeated use of LNG-EC for further intercourse during the same cycle was also associated with a higher risk for EP (AOR1 = 3.08, 95%CI: 1.09-8.71; AOR2 = 2.49, 95%CI: 1.00-6.19).A better understanding of the risk of EP following LNG-EC failure can optimize LNG-EC use and thus reduce the risk of EP.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200030, China.

ABSTRACT
Cases of ectopic pregnancy (EP) following levonorgestrel emergency contraception (LNG-EC) failure have been reported continuously, but whether there is an association between EP risk and LNG-EC is unclear. We concluded a case-control study to explore this association by recruiting 2,411 EP patients as case group, and 2,416 women with intrauterine pregnancy and 2,419 non-pregnant women as control groups. Odds ratios (ORs) and their 95% confidential intervals (CIs) were calculated and adjusted for potential confounding factors. Previous use of LNG-EC was not correlated with the EP. Compared to women who did not use contraceptives, current use of LNG-EC reduced the risk for intrauterine pregnancy (Adjusted OR [AOR] = 0.20, 95%CI: 0.14-0.27), but did not increase the risk for EP (AOR2 = 1.04, 95%CI: 0.76-1.42). Furthermore, compared to women who did not have further act of intercourse, women with unprotected further act of intercourse were at a higher risk of EP (AOR1 = 2.35, 95%CI: 1.17-4.71), and women with repeated use of LNG-EC for further intercourse during the same cycle was also associated with a higher risk for EP (AOR1 = 3.08, 95%CI: 1.09-8.71; AOR2 = 2.49, 95%CI: 1.00-6.19). A better understanding of the risk of EP following LNG-EC failure can optimize LNG-EC use and thus reduce the risk of EP.

Show MeSH
Related in: MedlinePlus