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Contraception. 1997 Jul;56(1):9-16.

A longitudinal study of birth control and pregnancy outcome among women in a Swedish population.

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Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden.


The prevalence of contraception and pregnancy outcome in the same women, at 19, 24, and 29 years of age, was assessed in a longitudinal cohort study using a postal questionnaire technique. A one-in-four random sample of all women born in 1962 and resident in the city of Göteborg in 1981, was obtained from the population register (n = 656). Respondents from 1981 were re-assessed in 1986 and 1991. Four hundred thirty women (66%) answered the questionnaire on all three occasions and are included in the analysis. Contraceptive usage was as follows (at 19, 24, and 29 years of age, respectively): oral contraception (OC) 47%/51%/22%; intrauterine device 3%/11%/19%; barrier methods 12%/12%/20%; depot gestagen 0/0.2%/0.4%; no contraception 39%/26%/25%. OCs had been taken at some time by 93%. Reasons give for cessation of OC were: contraception not required 10%/21%/20%; fear of OC 28%/32%/35%; menstrual disorder 17%/13%/14%; weight increase 20%/16%/15%; mental side effects 14%/ 21%/20%; desire to become pregnant 7%/33%/52%. Pregnancy outcome was as follows: Ever pregnant 17%/42%/ 71%; children 5% had 1-2 children/27% had 1-3 children/ 59% had 1-5 children; 12%/25%/30% > or = 1 legal abortion; 3%/8%/15% > or = 1 miscarriage; and > or = 1 ectopic pregnancy 0.2%/1.2%/2.1%. On all three survey occasions, more than 97% of the legal abortions were performed < or = 12 weeks gestation. The complication rate following legal abortion was 7%. The proportion of live births to the total number of pregnancies was 25%, 45%, and 61%. The relationship between method of contraception, history of pregnancy, legal abortion, and smoking habits was analyzed in detail. Despite the availability of effective contraception, the ratio of legal abortions to live births was high. Fear of side effects was the commonest reason for discontinuing OC.


Contraceptive use patterns and pregnancy outcomes were assessed in a longitudinal cohort study of 656 women (a 1-in-4 random sample) born in 1962 and residing in Goteborg, Sweden, in 1981. Included in the present analysis were the 430 women (66%) who returned all three postal questionnaires (1981 at age 19 years, 1986 at 24 years, and 1991 at 29 years). Contraception had been used at some point by 73% of women at age 19, 94% at age 24, and 97% at age 29. Contraceptive usage, by method, at ages 19, 24, and 29 years, respectively, was as follows: oral contraceptives (OCs) 47%, 51%, and 22%; IUD 3%, 11%, and 19%; barrier methods 12%, 12%, and 20%; depot gestagen 0, 0.2%, and 0.4%; and no method 39%, 26%, and 25%. 93% of respondents had taken OCs at some time in the 10-year study period; the major reasons for discontinuation were fear of side effects, menstrual disorders, weight gain, and mental side effects. Pregnancy outcomes at ages 19, 24, and 29 years, respectively, were as follows: ever pregnant 17%, 42%, and 71%; live births 5%, 27%, and 59%; 1 or more legal abortions 12%, 25%, and 30%; 1 or more spontaneous abortions 3%, 8%, and 15%; and 1 or more ectopic pregnancies 0.2%, 1.2%, and 2.1%. The proportion of live births to the total number of pregnancies was 25% at age 19 years, 45% at age 24 years, and 61% at age 29 years. The shifts in contraceptive use patterns over the 10-year study period reflect both improvements in available contraceptive technologies and changes in women's life situation with increasing age and parity.

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