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© 1980 Oxford University Press

research-article

Spontaneous Foetal Losses in Women Using Different Contraceptives Around the Time of Conception

S HARLAP1,*, P H SHIONO2 and S RAMCHARAN3

1,2,3 Contraceptive Drug Study, Kaiser-Permanente Medical Center, 1425 South Main Street, Walnut Creek, California 94596. Supported by contract Number NO1–HD–4–2761, from the Center for Population Research, NICHD.

* Present address: Department of Medical Ecology, Hebrew University of Jerusalem. Reprints from: S Ramcbaran, Contraceptive Drug Study, Kaiser-Permanente Medical Center, 1425 South Main Street, Walnut Creek, California 94596, USA.

Harlap S [Contraceptive Drug Study, Kaiser-Permanente Medical Center, 1425 South Main Street, Walnut Creek, California 94596], Shiono P H and Ramcharan S. Spontaneous foetal losses in women using different contraceptives around the time of conception. International Journal of Epidemiology 1980, 9: 49–56.

Spontaneous losses between the 5th and 27th weeks of pregnancy were measured in a prospective study of 32 123 women whose contraceptive history around the time of conception was known. Diaphragm use prior to conception was associated with a significant reduction in second-trimester losses, after taking into account the effects of age, parity, race, marital status, alcohol use, and previous spontaneous or induced abortions. Women who used oral contraceptives and stopped them more than one month prior to their LMP experienced a deficit of first-trimester losses but conceptions occurring immediately after stopping the pill were followed by a small but nonsignificant increase in spontaneous abortions. After oral contraceptive failures there was an increase in first-trimester losses, but no change in the incidence of second-trimester ones. IUD failures were followed by a significant two-fold increase in the risk of both first and second-trimester losses: no differences were detected between the different brands.

Received 5 September 1979


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