Contraceptive Failures in Overweight and Obese Combined Hormonal Contraceptive Users

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Abstract

OBJECTIVE:

To estimate weather contraceptive failure rates among combined oral contraceptive pill (OCP), patch, and vaginal ring users was associated with increasing body mass index (BMI).

METHODS:

Females enrolled in a large contraceptive study offering the reversible method of their choice at no cost were followed-up for 2–3 years. We compared the failure rates (pregnancy) among users of the OCP, transdermal patch, and contraceptive vaginal ring stratified by BMI.

RESULTS:

Among the 7,486 participants available for this analysis, 1,523 chose OCPs, patch, or ring at enrollment. Of the 334 unintended pregnancies, 128 were found to be a result of OCP, patch, or ring failure. Three-year failure rates were not different across BMI categories (BMI less than 25 8.44%, 95% confidence interval [CI] 6.1–11.5; BMI 25–30 11.03%, 95% CI 7.5–16.0; BMI more than 30 8.92%, 95% confidence interval 7.6–11.5). Increasing parity (hazard ratio [HR] 3.06, CI 1.31–7.18) and history of a previous unintended pregnancy (HR 2.82, CI 1.63–4.87), but not BMI, were significant risk factors for unintended pregnancy.

CONCLUSION:

Overweight and obese females do not appear to be at increased risk for contraceptive failure when using the OCP, patch, or vaginal ring.

LEVEL OF EVIDENCE:

II

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