Shingo Noi, Akiko Shikano, Ryo Tanaka, Kosuke Tanabe, Natsuko Enomoto, Tetsuhiro Kidokoro, Naoko Yamada, Mari Yoshinaga
The Pathways Linking to Sleep Habits among Children and Adolescents: A Complete Survey at Setagaya-ku, Tokyo
International journal of environmental research and public health
us food drug administrationapproved segesterone acetate ethinyl estradiol ringshaped contraceptive vaginal system known annovera sever pharma solutionsqpharma malm sweden inserted removed womans control 21 day 7 day regimen 13 cycles use aimed describe patterns ring expulsion time identify potential predictors expulsion evaluate impact expulsions method discontinuation pregnancy risk using data 2064 participants enrolled 2 multinational phase 3 clinical trials use contraceptive vaginal system examined data participants daily diaries documentation complete ring expulsion modeled odds reported expulsions time adjustment background demographic characteristics using mixedeffects logistic regression models random intercepts compared probability continuation report expulsions first cycle use using survival analysis hazards modeling determine expulsions first cycle use affected risk pregnancy calculated pearl indices participants 75 never experienced expulsions cycle use 91 97 experience expulsion 1 cycle incidence expulsion highest cycle 1 9 odds experiencing expulsions decreased half cycles 2 8 compared cycle 1 048 95 confidence interval 040058 cycles 9 13 expulsions third cycle 1 032 95 confidence interval 026041 experience expulsions 6284 experienced 2 expulsions per cycle participants study sites latin america vs united states higher odds experiencing expulsion odds ratio 195 95 confidence interval 145263 women higher education level higher odds experiencing expulsion notably parity age body mass index associated expulsion participants experienced expulsions cycle 1 likely discontinue use early hazard ratio 128 95 confidence interval 114143 participants expulsion pearl index participants expulsions cycle 1 399 95 confidence interval 129931 higher among participants reported expulsions pearl index 239 95 confidence interval 161341 overlapping confidence intervals indicate sufficient evidence demonstrate association expulsions pregnancy risk expulsions infrequent overall decreased subsequent cycles use associated body mass index parity early discontinuation product use higher among participants experienced expulsion cycle 1 although unclear whether pregnancy risk associated expulsions early recognition expulsions among users may identify higher risk discontinuation may highlight enhanced anticipatory counselling guidance may advantageous