A LONGITUDINAL-STUDY OF BIRTH-CONTROL AND PREGNANCY OUTCOME AMONG WOMEN IN A SWEDISH POPULATION

The prevalence of contraception and pregnancy outcome in the same wome n, at 19, 24, and 29 years of age, was assessed in a longitudinal coho rt study using a postal questionnaire technique. A one-in-four random sample of all women born in 1962 and resident in the city of Goteborg in 1981, was obtained from the population register (n = 656). Responde nts from 1981 were re-assessed in 1986 and 1991. Four hundred thirty w omen (66%) answered the questionnaire on all three occasions and are i ncluded 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%; depo t gestagen 0/0.2%/0.4%; no contraception 39%/26%/25%. OCs had been tak en at some time by 93%. Reasons given for cessation of OC were: contra ception not required 10%/21%/20%; fear of OC 28%/32%/35%; menstrual di sorder 17%/1All rights reserved.3%/24%; weight increase 20%/16%/15%; m ental side effects 14%/21%/20%; desire to become pregnant 7%/13%/14%. 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% greater than or equal to 1 legal abortion; 3%/8%/15% greater than or equal to 1 miscarriage; and greater than or equal to 1 ectopic pre gnancy 0.2%/1.2%/2.1%. On all three survey occasions, more than 97% of the legal abortions were performed less than or equal to 12 weeks ges tation. The complication rate following legal abortion was 7%. The pro portion of live births to the total number of pregnancies was 25%, 45% , and 61%. The relationship between method of contraception, history o f pregnancy, legal abortion, and smoking habits was analyzed in detail . Despite the availability of effective contraception, the ratio of le gal abortions to live births was high. Fear of side effects was the co mmonest reason for discontinuing OC. (C) 1997 Elsevier Science Inc.