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...en, M., Scheidt-Nave, C.sHormonal contraceptive use among adolescent girls in Germany in relation to health behaviorsand biological cardiovascular risk factorss(2011) Journal of Adolescent Health, 48 =-=(4)-=-, pp. 331-337.sDOI: 10.1016/j.jadohealth.2011.01.004sThis is an author manuscript.sThe definitive version is available at: http://www.sciencedirect.com/sHormonal contraceptive use among adolescent gir...

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...considered to have fewer adverse health effects because of this lower estrogenscontent and altered progestin; however, some studies with more recently introducedspreparations do not support this view =-=[9, 10]-=-.sEvidence on health risks of HC use among adolescents is scarce. Events such as venoussthrombosis, stroke, and myocardial infarction occur rarely in adolescents, thus, hard endpointsstudies would req...

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...disease risk.sElevated levels of serum hs-CRP, if not caused by an acute infection, have been associatedswith cardiovascular disease risk, in particular risk of atherosclerotic degenerative processess=-=[38]-=-. However, it is subject to debate whether hs-CRP is an indicator or an inducer ofsatherosclerotic processes [39]. To determine the clinical relevance of the observedsassociations of HC use and biolog...

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...considered to have fewer adverse health effects because of this lower estrogenscontent and altered progestin; however, some studies with more recently introducedspreparations do not support this view =-=[9, 10]-=-.sEvidence on health risks of HC use among adolescents is scarce. Events such as venoussthrombosis, stroke, and myocardial infarction occur rarely in adolescents, thus, hard endpointsstudies would req...

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...l health risk factors. In particular, we found no interaction between HC use andssmoking, although a synergistic effect of smoking and HC use on cardiovascular risk hassbeen described by some studies =-=[35, 36]-=-. Relative contributions of HC use on biologicalscardiovascular risk factors were small (<1 -12%).sThe clinical relevance of the association between HC use and established cardiovascular risksfactors ...

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... the survey consisted of all noninstitutionalized children and adolescentssaged 0-17 years living in Germany. The design, sampling strategy, and study protocol havesbeen described elsewhere in detail =-=[17]-=-. Briefly, a two-stage random clustered sample of thestarget population was drawn on the basis of a representative sample of German communitiess[17].sThe study was conducted according to a highly stan...

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...diovascular disease risk, in particular risk of atherosclerotic degenerative processess[38]. However, it is subject to debate whether hs-CRP is an indicator or an inducer ofsatherosclerotic processes =-=[39]-=-. To determine the clinical relevance of the observedsassociations of HC use and biological cardiovascular risk factors, tracking of risk factors andsthe development of subclinical disease in associat...

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...l health risk factors. In particular, we found no interaction between HC use andssmoking, although a synergistic effect of smoking and HC use on cardiovascular risk hassbeen described by some studies =-=[35, 36]-=-. Relative contributions of HC use on biologicalscardiovascular risk factors were small (<1 -12%).sThe clinical relevance of the association between HC use and established cardiovascular risksfactors ...

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...any. Family social statussscore was computed integrating information obtained from the parents’ questionnaire on bothsparents’ educational level and professional status as well as total family income =-=[17, 21]-=-.sFamily immigration status was assessed on the basis of the information collected onsnationality, country of birth, and year of immigration of both parents [17]. Girls were classifieds8 as having an ...

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...uctedsamong 14-17-year-old girls in Germany, despite methodological differences in study designs[22]. Our results are also similar to prevalence estimates reported by other westernsEuropean countries =-=[11, 23, 24]-=-.sIn contrast to a previous study among Finnish teenagers [25] but in agreement with studysresults obtained among adult women in Germany [26], we did not find an association of HCsuse with family soci...

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...gression models, we included pubertal stage as selfreported Tanner stage of pubic hair (stage 1: Tanner 1; stage 2: Tanner 2-3; stage 3: Tanners4-6) and menarche status (yes/no) as additional factors =-=[19]-=-.sBiological cardiovascular risk factors included blood pressure and serum concentrations ofstotal cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoproteinscholesterol (HDL-C...

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...f HC use and elevated SBP, DBP,sserum total cholesterol and LDL-C [11, 13-16]. Studies that were conducted in the 1970s ands1980s found decreased HDL–C levels among HC users as compared with nonusers =-=[16, 30]-=-.sIn contrast, in the present study, HDL–C levels were higher among HC users than nonusers,smost likely because of the differences in the progestin component between older and moresrecently developed ...

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...mates reported by other westernsEuropean countries [11, 23, 24].sIn contrast to a previous study among Finnish teenagers [25] but in agreement with studysresults obtained among adult women in Germany =-=[26]-=-, we did not find an association of HCsuse with family social status or individual components of this construct, that is, educational orsprofessional status or household income. As observed in the pre...

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... for HCs. As observed amongsteenagers in the present study, HC use among adult women was previously reported to bessignificantly higher in eastern German federal states than in western federal states =-=[26, 27]-=-,spossibly because of easier access to this contraceptive method in the former GermansDemocratic Republic [27]. Although differences in health and health-related behaviorsbetween children and adolesce...

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...27]. Although differences in health and health-related behaviorsbetween children and adolescents living in former East and West Germany have almostsdisappeared within the 20 years since reunification =-=[28]-=-, the mother’s preference maysconceivably affect the daughter’s choice of contraception method.sAn association between HC use and unhealthy lifestyle, in particular current cigarettessmoking, was foun...

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...f HC use and elevated SBP, DBP,sserum total cholesterol and LDL-C [11, 13-16]. Studies that were conducted in the 1970s ands1980s found decreased HDL–C levels among HC users as compared with nonusers =-=[16, 30]-=-.sIn contrast, in the present study, HDL–C levels were higher among HC users than nonusers,smost likely because of the differences in the progestin component between older and moresrecently developed ...

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...th other methods of contraception [1]. In addition, the use of HCs amongsadolescents may have positive effects on certain hormonal disorders such as dysmenorrhea,sirregular menstrual cycles, and acne =-=[2]-=-. However, HCs have also been associated withsadverse health effects. In epidemiological studies conducted among adult women,scardiovascular health risks, such as venous thrombosis, ischemic and hemor...

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...tives (HCs) have been recommended for the prevention of unintendedspregnancies among adolescents in Germany because they are considered relatively safe asscompared with other methods of contraception =-=[1]-=-. In addition, the use of HCs amongsadolescents may have positive effects on certain hormonal disorders such as dysmenorrhea,sirregular menstrual cycles, and acne [2]. However, HCs have also been asso...

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...s in others [11-14, 29]. Clustering of behavioralscardiovascular risk factors among adolescents has been previously observed to bes13 associated with an adverse biological cardiovascular risk profile =-=[13]-=-. Previous studiessconducted among adolescents reported an association of HC use and elevated SBP, DBP,sserum total cholesterol and LDL-C [11, 13-16]. Studies that were conducted in the 1970s ands1980...

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... HCs. This prevalencesestimate is consistent with results obtained from a previous interview survey conductedsamong 14-17-year-old girls in Germany, despite methodological differences in study designs=-=[22]-=-. Our results are also similar to prevalence estimates reported by other westernsEuropean countries [11, 23, 24].sIn contrast to a previous study among Finnish teenagers [25] but in agreement with stu...

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...uctedsamong 14-17-year-old girls in Germany, despite methodological differences in study designs[22]. Our results are also similar to prevalence estimates reported by other westernsEuropean countries =-=[11, 23, 24]-=-.sIn contrast to a previous study among Finnish teenagers [25] but in agreement with studysresults obtained among adult women in Germany [26], we did not find an association of HCsuse with family soci...

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...uctedsamong 14-17-year-old girls in Germany, despite methodological differences in study designs[22]. Our results are also similar to prevalence estimates reported by other westernsEuropean countries =-=[11, 23, 24]-=-.sIn contrast to a previous study among Finnish teenagers [25] but in agreement with studysresults obtained among adult women in Germany [26], we did not find an association of HCsuse with family soci...

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...fferences in study designs[22]. Our results are also similar to prevalence estimates reported by other westernsEuropean countries [11, 23, 24].sIn contrast to a previous study among Finnish teenagers =-=[25]-=- but in agreement with studysresults obtained among adult women in Germany [26], we did not find an association of HCsuse with family social status or individual components of this construct, that is,...

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...estin component between older and moresrecently developed oral contraceptives. Elevated levels of serum hs-CRP in association withsHC use have been previously described in studies of adolescent girls =-=[31]-=- as well as adultswomen [32-34]. In agreement with other studies, we did not find evidence for an associationsbetween HC use and homocysteine levels [31].sIn addition to previous investigations, the p...

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... remains unclear. The risk of cardiovascular events, insparticular stroke, or venous thromboembolism is considered low among adolescent HCsusers, unless a genetic predisposition for thrombosis exists =-=[2, 37]-=-. As risk considerablysincreases with age, heavy smoking is a contraindication of HC use for adult women,sespecially for those aged >35 years according to guidelines of the German Society ofsGynaecolo...