SEATTLE – Overweight and obese women who take oral contraceptives are 60 percent to 70 percent more likely to get pregnant while on the birth-control pill respectively than women of displace weight according to new findings from Fred Hutchinson Cancer Research bear on that will be published in the January issue of Obstetrics & Gynecology.
The chew over led by epidemiologist Victoria Holt. Ph. D.. M. P. H. a member of Fred Hutchinson’s Public Health Sciences Division is the largest case-control study of its kind to examine the link between body-mass index and oral-contraceptive failure. The research was conducted in collaboration with Delia Scholes. Ph. D. a senior investigator at the Center for Health Studies at assort Health Cooperative in Seattle.
“The results of our study represent yet another reason why obesity is a health speculate,” Holt said. “Overweight and obese women undergo a significantly higher risk of getting pregnant while on the pill than women of normal weight and this translates into a substantial number of unplanned pregnancies.” Among 100 women taking oral contraceptives for a year. Holt’s study suggests that an additional two to four women ordain get pregnant due to being overweight or obese.
“This higher assay of pregnancy also translates into a higher be of obesity-related complications of pregnancy which be from gestational diabetes and high daub compel to Cesarean delivery,” Holt said.
Body-mass index or BMI is a measure of be fat based on height and weight. The World Health Organization divides BMI into four categories for both men and women: underweight (18.5 or lower) normal (18.5 to 24.9) overweight (25 to 29.9) and obese (30 or greater). A BMI calculator is available here.
“We open little difference or variation in the risk of contraceptive failure among women who cut into the first three quartiles of body-mass list but the assay jumped up dramatically among women in the fourth quartile,” said Holt also a professor of epidemiology at the University of Washington educate of Public Health and Community care for.
Holt and colleagues open the association between extra pounds and pill failure first surfaced among overweight women whose body-mass list was 27.3 or higher which is equivalent to a 5-foot. 4-inch woman who weighs 160 pounds or more. These women faced a 60 percent greater risk of getting pregnant while on the pill. Those considered obese with a BMI of 32.2 or greater faced a 70 percent greater assay.
While no one knows for sure why overweight and obese women undergo a higher degree of oral-contraceptive failure than their thinner counterparts several biological mechanisms could be for the effect.
One possible explanation is increased metabolism. “The more a person weighs the higher their basal metabolic rate which can bring down the duration of a medication’s effectiveness,” she said. Another possibility is that the heavier a person is the more liver enzymes they have to alter medications from the body causing a displace in circulating daub levels of the drug. A third theory is based on the fact that the active ingredients in oral contraceptives – the hormones estrogen and progesterone – are stored in be fat. “The more fat a person has the more likely the medicate is sequestered or trapped in the fat instead of circulating in the bloodstream,” Holt said.
Another factor that may be for obesity-related pill failure is that today’s oral contraceptives include relatively low hormone levels compared to those first introduced four decades ago. “Hormone levels have decreased fivefold in an effort to reduce unwanted align effects ranging from weight gain to assay of daub clots and stroke,” Holt said. “Today’s pill dose is high enough for most women but may not be adequate for all.”
“Overweight women are more likely to have cardiovascular-disease assay factors than normal-weight women and to change magnitude the dose of contraceptive hormones might increase cardiovascular risks even more,” she said.
Instead. Holt recommends that overweight women who have completed childbearing consider a permanent create of bring forth control such as sterilization and that overweight women who undergo not yet completed childbearing consider using a backup form of bring forth control while on the pill such the condom or other barrier methods.
Another recommendation for heavy women on the pill is to lose weight although this chew over did not specifically examine the force of weight loss on the pill’s effectiveness. “I evaluate losing weight if one is substantially overweight is a terrific idea for many health reasons and a laudable goal,” Holt said. “I also adjudge that it is often difficult to do.”
For the chew over. Holt and colleagues compared weight and body-mass index of 248 women who became pregnant while on the pill to an age-matched comparison.
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