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肥胖在世界范围内不断增加。虽然关于肥胖和避孕效果相关性的可用数据有限,但肥胖妇女和正常体重妇女的意外妊娠风险相似。尽管肥胖妇女的口服避孕失败率并不比正常体重的妇女高,不过关于肥胖和口服避孕药效果相关性的数据存在着分歧。由于肥胖会增加静脉血栓栓塞风险,在使用激素联合疗法避孕时会额外增加这种风险。减肥手术可能会导致生育率增长,而术后建议中就包括避免术后头一年怀孕这一条。临床医生往往并不了解女性病人的避孕方式和效果,因此今后非常有必要推行长效的有效避孕方法,并建立共识性的指南。
Obesity is constantly increasing worldwide. Although available data on the association between obesity and contraceptive effectiveness are limited, the risk of unwanted pregnancies among obese and normal-weight women is similar. Although the rate of oral contraceptive failure in obese women is not higher than in normal-weight women, there is disagreement with the data on the effects of obesity and oral contraceptive use. Because obesity increases the risk of venous thromboembolism, this risk is additionally increased when contraception with hormonal combination therapy is used. Bariatric surgery may result in an increase in fertility, and postoperative recommendations include the one to avoid pregnancy for the first year after surgery. Clinicians often do not understand the contraceptive methods and effects of female patients. Therefore, it is necessary in the future to implement long-term and effective contraceptive methods and establish consensus guidelines.