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February 24, 1984

Mortality Among Young Black Women Using Contraceptives

Author Affiliations

From the Division of Reproductive Health, Center for Health Promotion and Education, Centers for Disease Control (Drs Ory, DeStefano, Peterson, Guidotti, and Layde and Mss Jones, Wingo, and Levenson and Mr Rubin), and Emory University Family Planning Program (Dr Hatcher and Ms Michelson), Atlanta.

JAMA. 1984;251(8):1044-1048. doi:10.1001/jama.1984.03340320030022

Data on the risk of death associated with various contraceptive methods are incomplete. Therefore, we analyzed the mortality rates for young, black inner-city women who used one of four methods of contraception—oral contraceptives, depomedroxyprogesterone acetate, intrauterine (contraceptive) devices, and barrier methods. The subjects were 30,580 15-to 44-year-old women who enrolled at a family planning clinic between 1967 and 1972 and who were observed by monitoring death certificates through the end of 1977. Forty percent of the 218 deaths observed were from accidents and violence. Use of this family planning clinic greatly reduced the risk of death from childbearing; only two deaths were associated with pregnancy and childbirth, compared with the 24 deaths expected. Overall, users of the four methods died at similar, low rates. Given that this study involves considerable loss to follow-up, possible acute effects of contraceptives (eg, infections or thrombosis) are more accurately estimated than possible long-term effects (eg, cancer).

(JAMA 1984;251:1044-1048)