ECE Award Winner: FACTORS ASSOCIATED WITH THE CONTRAINDICATED USE OF ORAL CONTRACEPTIVES IN BRAZIL, VIGITEL, 2008
Despite the widespread use of oral contraceptives (OC) in Brazil, little is known about their proper use, or contraindications. In this context, we aimed to investigate the prevalence of contraindications to OC use and associated factors in the Brazilian population.
METHODS:
We studied 20,454 women who responded to the telephone survey called VIGITEL (Telephone Survey Surveillance System for Risk and Protective Factors for Chronic Diseases), in 2008. From the total women, 3,985 reported OC use (23.2%). The OC contraindicated use was defined when women presented at least one of the following conditions: hypertension; cardiovascular disease such as myocardial infarction and stroke; diabetes; been a smoker and older than 35 years concomitantly. We evaluated the prevalence of contraindicated use among those who use OC and among the non-users as well. The contraindicated use associated factors were evaluated only for those who were OC users. Prevalences, prevalence ratios (PR) and 95% confidence intervals (95%CI) were estimated.
RESULTS:
Approximatelly 21% (95%CI: 19.7-21.9) of the women presented at least one contraindication to OC use. Of these, 11.8% are OC users. The more frequent contraindication condition was hypertension (15.1%). Most of the contraindicated women had 33-44 years old (49.5%) and low educational level, 0-8 years (53%). Contraindication prevalence among OC users was higher among women with low educational level (0-8 years of schooling) (PR=3.76; 95%CI 2.44-5.80; p<0,000) and aged between 45 and 49 years old (PR=5.88; 95%CI 3.30-10.40).
CONCLUSIONS:
These results indicate the possible existence of an undesirable inequality in the reproductive health care of Brazilian women. Therefore it is necessary to establish affirmative policies capable of promoting fairness for those who face greater difficulties in accessing public services network.