No período pós-parto o uso dos contraceptivos orais combinados é tão seguro quanto o uso dos progestativos orais?
Bibliographic record
Abstract
Introduction: Hormonal Contraception (HC) after childbirth is a public health issue of global importance, with repercussion for both mother and child. Objectives: To determine the safety of Combined Oral Contraceptives (COCs) and Progestogen-only pills (POPs) in postpartum women and breastfed children. Methods: The author searched MEDLINE, Guidelines Finder, National Guideline Clearinghouse, Canadian Medical Association, Infobase, The Cochrane Library, DARE, Bandolier, TRIP, InfoPoems and Scientific Societies, using the MeSH terms: Contraceptives, Oral; Safety; Postpartum Period; and the term Postpartum. The search was limited to articles published between January 2000 and April 2008 in English, Portuguese, French and Spanish. The categories of the World Health Organization Medical Eligibility Criteria for Contraceptive Use (WHOMEC) were used to compare results. The Strength of Recommendation Taxonomy (SORT) of the American Family Physician was used to assess the Level of Evidence. Results: Two meta-analysis, one systematic review, two evidence based reviews and five guidelines met the inclusion criteria. Safety for Women: there is theoretical concern regarding the association between COCs use up to three weeks postpartum and the risk of thrombosis. POPs can be related with the development of Type 2 Diabetes Mellitus in breastfeeding Women. Safety for breastfed children: there is evidence that there is no consistent change in breast milk production, child growth or weight, with the use of HC. Conclusion: The finding that pharmaceutical companies conducted most of the trials on oral contraceptives raises concerns about potential commercial biases. It would be advisable to do high quality, long-term, controlled and randomised studies about the safety of COCs and POPs in the postpartum period.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".