Use of oral contraceptives by adolescents and its consequences in Finland 1981–1991

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Citations from the Literature

Use of ord cootraceptives by adolescents sod its comeqoeoces in FInIaod 1981-91 Rimpela AH; Rimpela MK; Kosunen EA-L Department of Public Health, University of Oulu, Aapistiez, SF%I220 Oulu, FIN BR MED J 1992 305/6861 (1053-1057) Objectives-To study use of oral contraceptives among Finnish teenagers during 1981-91 and how abortions, childbirths, sexually transmitted diseases, and cardiovascular diseases changed during this period. Design - Biannual cross sectional surveys with mailed questionnaires from 1981 onwards and analysis of national statistics. Setting - Finland. Subjects - A nationwide sample of 14, 16, and 18 year olds. Sample size varied from 1249 to 3887 and response rate from 85 to 94%. Main outcome measures - Proportion taking oral contracep tive, fertility and abortion rates, hospital discharge rates, rates of sexually transmitted diseases. Results - The proportion of teenagers taking oral contraceptives increased steadily. In 1991 the percentages among 14, 16, and 18 year olds were 2%, 18%, and 4l%compared with 0.2%, 7% and 22% in 1981. Most users had a steady partner (80% of 16 year olds and 85% of 18 year olds). By 1989 rates of abortion had fallen from lUlOOO to 9.3/1000 in 16 year olds and from 25/1000 to 19.2/1000 in 18 year olds; fertility rates had fallen from 4.5/1000 to 2.3/1000 and from 23.50000 to 15.3/1000, respectively. Rates in 14 year olds fell only slightly. Gonorrhoea infection fell and HIV infection remained rare. Rates of hospital discharge after thromboembolic venous disease rose slightly. Conclusions - The increased use of oral contraceptives is the most likely explanation for decreasing abortion and fertility rates among teenagers. Increased reliance on the condom because of the threat of AIDS may increase unwanted pregnancies. Oral conhqtives MO5

and gymcologic cancer: An update for the

Kaunitx AM Department of Obstetrics and Gynecology, University Florida Hlth Science Ctr., 653 W. 8th Street, Jackson, FL 32209, USA AM J OBSTET GYNECOL 1992 167/4 II SUPPL. (11711176) The most recent statistical evidence confirms a protective effect of oral contraceptive use against ovarian and endometrial cancers. Studies of the association between oral contraceptive ding factors; however, results suggest that the overall risk of invasive cervical neoplasia is not increased. Although the association between oral contraceptive use and breast cancer remains controversial, existing data strongly suggest that overall risk of breast cancer is not increased by the use of oral contraceptives. In most candidates for oral contraceptive use, the benefits greatly outweigh the risks. Epidemiology of the noocoatraceptive

effects of oral con-

tT9CeptiVeS

Stergachis A Department of Pharmacy/Epidemiology, School of Pharmacy, University of Washington, Seattle, WA 98?95, USA Int J Gynecol Obstet 41

AM ,J OBSTET GYNECOL 1992 167/4 II SUPPL. (11651170) Epidemiologic studies have made major contributions to our understanding of oral contraceptive safety. The findings of major studies of the risk of cardiovascular disease and neoplasia associated with oral contraceptive use are reviewed, with discussion of the many factors to be considered in the interpretation of conflicting results. Mortality data that were based on earlier oral contraceptive formulations, dosage, and usage patterns may not be relevant to current practices. Recent studies suggest that reduced doses of estrogens and progestins in current oral contraceptive formulations and better screening of patients have reduced the risks of cardiovascular disease associated with oral contraceptive use, with the most important exception being an increased risk among older women who smoke. While most epidemiological studies demonstrate no overall association between oral contraceptives and breast cancer, unanswered questions remain concerning this relationship. Cootraceptive me projections: 1990 to 2010,

Trussell J; Vaughan B Office of Population Research, 21 Prospective Avenue, Princeton, NJ 08544, USA AM J OBSTET GYNECOL 1992 16714 II SUPPL. (11601164) Factors that will affect both contraceptive use and choice of method during the next 20 years are reviewed. Two factors are predictable: the changing age distribution of women and the revised upper-age limits for oral contraceptive use, with the effect of the latter as yet unknown. Less predictable factors include the number of women in each group at risk for pregnancy, the effects of delayed childbearing and sterilization, and the impact of new contraceptive methods. Unpredictable factors include adverse publicity about oral contraceptives and breast cancer, concern about sexually transmitted diseases and acquired immunodeticiency syndrome, and changes in the availability of legal abortion. Numbers of women using oral contraception, other reversible methods, sterilization, and no method are projected from 1990 to 2010 under the assumption that use patterns in each age group resemble those observed in 1988. We conclude that discrepancies between projections of contraceptive use and fact are likely to occur because of the unpredictable nature of these few important variables.

HIV-INFECTION The me of viral culture and p24 antigen testing to diagnose bomao immunodeficiency virus infection in monates

Burgard M; Mayaux M-J; Blanche S; Ferroni A; GuihardMoscato M-L; Allemon M-C; Ciraru-Vigneron N; Firtion G; Floch C; Guillot F; Lachassine E; Vial M; Griscelli C; Rouxioux C; Allisy C; Annengaud D; Babinet JM; Balde P; Fade1 FB, et al Laboratoire de Virologie, Hopital Necker-Enfants Malades, 149 rue de Sevres. 75015 Paris, FRA NEW ENGL J MED 1992 327/17 (1192-l 197)