[HN Gopher] Any type of hormonal contraceptive may increase risk...
___________________________________________________________________
Any type of hormonal contraceptive may increase risk of breast
cancer
Author : AiaAidan
Score : 95 points
Date : 2023-03-25 17:59 UTC (5 hours ago)
(HTM) web link (www.ox.ac.uk)
(TXT) w3m dump (www.ox.ac.uk)
| sterlind wrote:
| Statistically significant, but slight (~25% increased risk, on
| average.) Still not great.
|
| Obviously, copper IUDs are an alternative for many, though they
| have their downsides. One of the big uses of hormonal
| contraception is managing heavy periods, PMDD and other medical
| conditions. I had a friend who would throw up for days every time
| she was on her period. It went away pretty completely on birth
| control.
| twawaaay wrote:
| The magnitude of risk increase in percentage has to be
| understood in context of baseline probability.
|
| 25% additional chance of getting hit by lightning and 25%
| additional chance of getting heart disease are two completely
| different results -- I don't mind the first but I would be
| scared by the second.
|
| About 13% of women develop breast cancer during their lifetime.
| 25% increase is then very significant, this is about additional
| 4% chance of getting cancer.
| jnwatson wrote:
| Thank you for the context. The net increase in risk is what I
| was looking for.
| projectazorian wrote:
| > About 13% of women develop breast cancer during their
| lifetime. 25% increase is then very significant, this is
| about additional 4% chance of getting cancer.
|
| The study didn't measure lifetime risk, so your assertion is
| not correct. It measured risk of acquiring breast cancer
| before age 49. This is not the age when most women get breast
| cancer. Average age of onset for breast cancer in the US is
| 62.
| twawaaay wrote:
| While you are partly correct, the study just "didn't
| measure". It means the study does not say anything about
| getting cancer after 49. What it does not say is that there
| isn't any increase after the age women typically stop using
| contraceptives.
|
| In particular, since we don't know the mechanism in which
| contraceptives cause cancer, we can't say whether trend
| ends when women stop taking them or will increase their
| chance of getting cancer for the rest of their lives.
| projectazorian wrote:
| Yes, however, we have over a half century of data on
| hormonal contraception at this point, more than enough to
| measure the effect on lifetime risk.
|
| This very large meta-study showed the increased risk is
| no longer significant about ten years after stopping use:
| https://pubmed.ncbi.nlm.nih.gov/8656904/
|
| (btw, got that link from this article about the study in
| the OP, which points out potential confounders:
| https://www.statnews.com/2023/03/21/small-rise-breast-
| cancer...)
| yieldcrv wrote:
| > The researchers also note that although these findings provide
| evidence about the short-term associations between hormonal
| contraceptives and breast cancer risk, they do not provide
| information regarding longer-term associations, or the impact of
| total duration of contraceptive use on breast cancer risk, since
| information on a woman's prescription record prior to joining a
| participating GP practice would not have been available within
| the CPRD database.
| projectazorian wrote:
| The headline is somewhat deceptive. This study doesn't assess
| lifetime risk, just risk before age 49. Since most breast cancers
| are diagnosed well after age 49, it needs to be assessed in that
| light.
| justinator wrote:
| Hopefully soon, doctors that prescribe birth control for things
| unrelated to birth control will now stop doing that as that's a
| reasonably bad thing to do (IMHO IANAD)
| emodendroket wrote:
| Is there some other solution for the problems it solves?
| justinator wrote:
| Birth control is sometimes prescribed to help with heavy
| period flow, which could be a symptom of a much worst issue
| (endometriosis). But birth control is also prescribed to help
| control acne, which in my humble, unprofessional opinion is
| not a good use, and the risks far outweigh the benefit.
| Weight loss is another reason it's prescribed. These sorts of
| off-label perscription for a hormone are not... great IMHO.
|
| Are there other solutions to acne, and weight loss? Yes.
| Endometriosis is far more complicated.
| emodendroket wrote:
| It also is used to help with irregularities associated with
| periods. Seems like sidestepping the issue to say there are
| other acne remedies.
| justinator wrote:
| _> Seems like sidestepping the issue to say there are
| other acne remedies._
|
| My opinion is that estrogen hormone therapy is not the
| best course of action for acne and is prescribed far too
| much.
|
| I literally do not know what your beef is with my
| opinion, since you do not state yours, you just write in
| weird, obtuse statements, which is common on hn in, I
| would assume, an attempt to look smart on a subject, in
| which you are not. See also: contrarianism.
| cfu28 wrote:
| I mean, this isn't new information for doctors. It's a pretty
| well known fact that estrogen agonists can increase risks for
| breast cancer - that's why decisions made about birth control
| are patient centric and consider the patients risk factors.
|
| For reference, risks of breast and cervical cancers are
| increased in women who use oral contraceptives, whereas the
| risks of endometrial, ovarian, and colorectal cancers are
| actually reduced.
|
| Also IANAD
| twawaaay wrote:
| In general any type of hormonal anything is probably dangerous.
| Endocrine system is incredibly complex and connected in many
| different, mostly unknown ways.
|
| And contraceptives play with hormones that are central to what
| makes women women.
|
| These hormones are not just limited to regulating when eggs are
| released from ovaries, they take part in a lot of other
| processes. It is absolutely not surprising then that there will
| be other effects of long term hormonal supplementation.
|
| I think the best course of action would be to work on other, non-
| hormonal contraceptive alternatives.
| f38zf5vdt wrote:
| > In general any type of hormonal anything is probably
| dangerous. Endocrine system is incredibly complex and connected
| in many different, mostly unknown ways.
|
| By that logic sugar should be a controlled substance and we
| should all be gonadectimized. Gonadectimized animals almost
| always live longer.
|
| > And contraceptives play with hormones that are central to
| what makes women women.
|
| Weirdly estrogen in utero is central to what makes male mice
| male mice, and adult men adult men (20-55 pg/mL estradiol in
| adult men or about 1/10th the level of adult women). Estradiol
| plays many important roles in the body of all human adults.
|
| > These hormones are not just limited to regulating when eggs
| are released from ovaries, they take part in a lot of other
| processes. It is absolutely not surprising then that there will
| be other effects of long term hormonal supplementation.
|
| > I think the best course of action would be to work on other,
| non-hormonal contraceptive alternatives.
|
| Maybe, maybe not, since chronic use of any medication will
| result in chronic side effects and physical interventions such
| as copper IUDs are also associated with a host of serious side
| effects. The best course of action would be to develop
| interventions that are safe in animal models, give them to
| humans for a while, and monitor the outcomes, which is what is
| going on here.
|
| I'm surprised that the outcomes observed aren't worse, given
| how strongly carcinogenic estrogens are on a dose-dependent
| basis in animal models. Hormones are strange. Women with many
| children have reduced amounts of breast cancer despite being
| exposed to absolutely enormous levels of estrogens and
| progesterone during and after pregnancy.
| lockhouse wrote:
| I'm curious if hormonal transgender treatments will have
| similar long term effects.
| jolux wrote:
| It's already suspected though not proven (as far as I know)
| that estradiol increases breast cancer risk, but I imagine
| most of that is because it encourages significant breast
| tissue growth.
| ghqst wrote:
| If I remember correctly this is at high dosages, so it
| should be much safer in a normal dosage used for hrt.
| gizmo686 wrote:
| HRT as applied to gender dysphoria in transgender women
| absolutely causes breast tissue growth. That is one of
| the desired effects. Seeing as 99% of breast cancers
| occur in women, and HRT causes the patient to have very
| female like breasts, it would be surprising if the
| patient did not see an increased risk of breast cancer
| compared to not taking HRT. Weather or not their risk is
| higher than the baseline risk for women is less obvious.
| NineStarPoint wrote:
| It probably will yes. But it's also measured against the
| heavily increased suicide risk of trans people who aren't
| able to transition.
| unvx-n-banned wrote:
| [flagged]
| blindriver wrote:
| Every single girlfriend I had, I asked her to get off
| contraceptives because of the medical dangers and I didn't want
| to be responsible for any problems associated with it. Instead I
| took responsibility for making sure she wouldn't get pregnant.
| One of my girlfriends actually got mad at me because I was *too*
| careful about getting her pregnant, and interpreted that as me
| not wanting to get married to her (which since we're not together
| ended up being true I guess).
|
| This doesn't work for everyone but I'm fairly responsible, and no
| accidental pregnancies, so it worked for everyone I was with. The
| same way went for my wife as well, and we have 2 kids now, with
| no accidentals ones. I'm going to teach my son this as well, that
| the responsibility is on both parties but as the man you need to
| control what you can control and don't leave things to chance,
| especially something as life changing/destroying as an accidental
| pregnancy.
| xyzelement wrote:
| You are getting weird hate here. You identified a health risk
| someone you cared about / loved was taking and strongly
| encourage them to avoid it (and offered other solutions)
|
| This is exactly what a proper partner does. Obviously you
| didn't force anyone to do it, but being passionate about such a
| topic is totally valid.
|
| Your story reminds me of mine though - encouraged female
| friends to avoid the pretty obvious health risk. And also have
| two kids now and never before :)
| mentalpiracy wrote:
| >>> This doesn't work for everyone but I'm fairly responsible
|
| chivalrous, even.
|
| /s
| afavour wrote:
| To be clear: you would never be in any way responsible for
| problems associated with your partner taking hormonal birth
| control because it is a choice they make themselves for their
| own body.
|
| > Instead I took responsibility for making sure she wouldn't
| get pregnant
|
| You have to understand what a big statement that is. If she
| _does_ get pregnant there's only one person guaranteed to have
| to deal with the consequences of that, and that's her. Being
| hesitant to transfer the responsibility to you is very
| rational, being mad at you over the topic is understandable.
|
| I know your intention is good throughout here but there's an
| implication that you know what's better for their bodies than
| they do. A better approach (IMO) is to inform them of the risks
| (which you're right they may not know) and let them make their
| own choice.
| throwbadubadu wrote:
| > If she does get pregnant there's only one person guaranteed
| to have to deal with the consequences of that, and that's
| her.
|
| Don't get that, in most jurisdictions there is an almost
| guaranteed second one?
| projectazorian wrote:
| No, because even if she chooses to terminate the pregnancy
| and not tell the other party a thing, she is still
| guaranteed to have to deal with the consequences of that
| decision. Or if she miscarries before she even knows she is
| pregnant, she has to deal with that, it's not a pleasant
| experience for anyone. Etc.
| thfuran wrote:
| >it is a choice they make themselves for their own body
|
| But not a choice made in a vacuum. It's a choice made in the
| context of their relationship.
| afavour wrote:
| Not entirely, no. Women take birth control for a number of
| reasons unrelated to pregnancy:
|
| https://www.webmd.com/sex/birth-control/ss/slideshow-
| birth-c...
|
| The "context of a relationship" part is when a couple
| decide to cease birth control in order to have a child
| together. The OP is talking about still using birth
| control, just different birth control that he would prefer
| she use over the alternatives. Ultimately that should be
| her choice because the end result to him (no pregnancy) is
| the same.
| thfuran wrote:
| >Women take birth control for a number of reasons
| unrelated to pregnancy
|
| Yes, but don't forget about the elephant in the room:
| There are a lot of women on birth control who wouldn't be
| if they weren't trying to avoid pregnancy.
|
| >Ultimately that should be her choice.
|
| Were you under the impression that he was physically
| preventing his girlfriends from taking birth control?
| klyrs wrote:
| I'm not sure if it counts as "the elephant in the room"
| when that's the stated purpose of the medication.
| thfuran wrote:
| The elephant that is the room?
| [deleted]
| Melingo wrote:
| My wife is doing it with nothing more than an app for 6 years
| while using some hormone kit before.
|
| I'm quite surprised how well this works but we are in a stable
| relationship.
|
| With or without plan b it would not be the end of our life's if
| we would suddenly getting a child.
|
| Not sure how I would see it if I would be 20 and not above 30
| lazyasciiart wrote:
| Wow. I'd probably break up with a guy who "asked me to get off
| contraceptives". If you want to be responsible about preventing
| pregnancy, that's fantastic. If you feel like that's any more
| than _an input_ to her decision of whether to be on it, that 's
| a pretty fundamental overreach.
| warent wrote:
| Maybe I'm being overly generous, it seems like it may be
| possible for this kind of thing to be more of a request out
| of support/concern for a loved one's health, rather than one
| of control or knowing better than a woman. It has been my
| understanding that many men don't consider such things.
|
| My lady has had horrendous experiences with hormonal
| contraceptives. Based on what we know of it, if she ever
| expressed wanting to try it again, I'd ask she reconsiders,
| or that we explore other options. She would appreciate that
| as being thoughtful (not as me claiming to know what's better
| for her, better than herself.)
|
| Maybe it's all about context, I'm not sure
| practice9 wrote:
| > Maybe it's all about context, I'm not sure
|
| +100
|
| For everyone the circumstances and relationship dynamics
| are different.
|
| And it's kind of disheartening to read a well-intentioned
| comment, see people assuming their own completely different
| context and then getting slightly aggressive about it.
| throwntoday wrote:
| Go to any relationship subreddit and you'll see countless
| comments where the slightest misstep is treated as some
| indellible sin. It's terrifying how quickly these people
| would forsake a loved one. So many unbelievably jaded and
| cynical people influencing the thoughts of others.
| emodendroket wrote:
| Well, we've also been given the context that at least one
| person in the relationship got upset with the demand.
| warent wrote:
| It's only disheartening to me because woman live in a
| society where men perpetually behave like we know what's
| best for them.
|
| What you're reading as aggression, I'm reading as a
| reasonable response to a perfectly plausible alternative
| interpretation, which is that he knows what's best for
| his girlfriends better than they do for themselves.
|
| So many men have this corrupt mode of thinking that there
| is now an entire US state issuing bounties on women
| seeking control over their own bodies.
| tines wrote:
| > woman live in a society where men perpetually behave
| like we know what's best for them.
|
| Everyone lives in a society where everyone else behaves
| like they know what's best for them. Men currently happen
| to have more power to enact their plans, but it's about
| power, not about gender, and all people who seek power
| think that they know best.
| hdjjhhvvhga wrote:
| > a perfectly plausible alternative interpretation, which
| is that he knows what's best for his girlfriends better
| than they do for themselves.
|
| We are literally commenting on the article confirming
| using hormonal contraceptives increases the risk of
| cancer. So if your partner is using these you basically
| have two options: 1) ignore the issue and maybe not even
| mention it to her as this could be misinterpreted as
| influencing her decision, 2) address it out of pure
| concern for her future, even years ahead when you're no
| longer together.
| projectazorian wrote:
| Discussing changes to birth control decisions in the
| context of a long term partnership is not, in my opinion,
| the same as having a policy of telling every woman you date
| to stop using contraceptives.
| warent wrote:
| You're right. However they did say they "ask" not "tell";
| it was not necessarily a demand. It's hard to know
| exactly how the conversations went
| hdjjhhvvhga wrote:
| I see your point but I think the parent didn't mean "ask" as
| in "told", it's obvious (at least to me!) that such decisions
| are taken by the woman only. I interpret this as, "I take the
| full responsibility for not making you pregnant. You can
| relax now and you don't need to increase the risk of getting
| cancer out of fear of pregnancy."
| kerpotgh wrote:
| [dead]
| blindriver wrote:
| Meh. It's not particularly controversial so you're being
| overly dramatic.
|
| I didn't force anyone, we had an adult conversation about it
| and all my gfs were on the same page. If any one of my gfs
| wanted to stay on contraceptives in the first place, then
| great, I would still do the exact same thing to avoid getting
| her pregnant in case she missed a day, etc. My wife wasn't on
| contraceptives in the first place so it was basically a non-
| conversation.
|
| I think having an adult conversation is basic expectations
| for any healthy relationship. If you interpret broaching a
| subject as being cause for breaking up with someone... well,
| that's your prerogative.
| warent wrote:
| Communication is a two way road. When you're talking about
| a sensitive topic and people don't know the context of you
| who are, don't be surprised when you are interpreted in a
| negative light.
|
| Based on your schoolyard dismissiveness here, it looks like
| they're spot on and you don't actually care much for adult
| conversations. You can dismiss that all you want but when
| people view us negatively in situations like this, it only
| hurts ourselves, so it's usually our responsibility to
| communicate better
| blindriver wrote:
| I don't feel the need to expend energy on anyone who
| immediately takes an overly negative opinion on a fairly
| benign sentence. We both know that nothing I say will
| change anyone's opinion, so why pretend that I should
| defend myself?
| fsckboy wrote:
| > _Meh. It 's not particularly controversial so you're
| being overly dramatic._
|
| you're denying you have any unconscious motivation to "be
| controlling," as you again display in your response to GP's
| reasonable personal opinion.
| blindriver wrote:
| I thought the overly negative response unreasonable, and
| I have enough experience on the Internet to know that
| nothing I write will change their opinion, so I don't
| want to extend the conversation.
|
| I don't feel any particular need to defend my "Internet
| honor" and if anyone wants to interpret my post as some
| Handmaid's Tale order for women to submit to my demands,
| well that's their prerogative.
| pfannkuchen wrote:
| Isn't any "request" an input only? As opposed to a "command".
| asmor wrote:
| It very much depends on context where request end and
| coersion starts. I'd be uncomfortable handing control over
| contraception use over to someone I've known for not so
| long. Just like a lot of guys use condoms because they
| don't trust the word of a women when she's saying she's on
| contraceptives.
| projectazorian wrote:
| In places like the US where women's reproductive rights are
| highly contested, many women don't take well to men making
| unsolicited requests about their birth control decisions.
| Perhaps this isn't the case everywhere, but this site has a
| very US-heavy readership so it seems reasonable to have
| that context be the default.
| xyzelement wrote:
| The person who started this thread was having a
| conversation with his girlfriend as part of a committed
| relationship, which seems way more important context than
| what you think is "contested in the US"
| projectazorian wrote:
| "Every single girlfriend I had, I asked her to get off
| contraceptives" is the tone of someone who is not
| interested in conversation and wants control. Bottom
| line.
| xyzelement wrote:
| I feel like I am taking crazy pills. How does the word
| "ask" imply control? They can say no.
| shawnz wrote:
| When your boss asks you to take a ticket, when a parent
| asks their son to clean their room, when a cop asks a
| citizen to identify themselves, you don't think those
| situations imply control? When a romantic partner asks
| you to change the drugs you are taking, don't you think
| there is some implication that their satisfaction with
| the relationship is contingent on it? Maybe we are
| getting too into the semantics here but I think it's
| pretty overbearing to make such a request and position it
| as anything more than a suggestion.
| xyzelement wrote:
| When a cop "asks," the citizen doesn't get to tell her to
| fuck off. The control is implied by the role not by the
| word "ask."
|
| This dude's girlfriends are free to tell him to fuck off
| (as one did) so there's no actual control.
|
| There's a difference between "control" and "being on the
| same page about big deal stuff." I don't think my wife
| would marry me if I was a heavy drug user for example.
| That's not her controlling my life, it's her having a
| standard for herself. If we are not on the same page we
| just don't get married.
|
| Presumably this dude doesn't want to date/marry someone
| who takes on heavy health risk when other options are
| available, especially when the nature of his can impact
| fertility and children. That's a very reasonable stance
| for him to take in his own life.
| pfannkuchen wrote:
| Maybe I live in a bubble, but the disagreement tends to
| be between different regions, not between individuals
| within a region. So unless the woman is a transplant from
| a pro reproductive rights region to an anti reproductive
| rights region, I don't think the sort of interpersonal
| conflict you have in mind is likely to occur, where the
| man is vehemently anti reproductive rights and the woman
| vehemently pro. At least I believe it happens
| infrequently enough to not assume it as a default.
| throwntoday wrote:
| Why does it upset you that GP would be concerned for his GF's
| health? I also ask my GF's not to take oral contraceptives
| because of guilt that they're doing damage to their body for
| me. None have ever responded negatively, and at the end of
| the day it was a request. All agreed they did not feel great
| when taking the pills, but continued because of pressure by
| society/previous partners.
| projectazorian wrote:
| Because it's likely that you and GP do not understand the
| risks as well as you think you do. You are likely not a MD,
| and even if you were, you wouldn't be the expert on your
| partner's body, they are. The lack of humility is the
| issue.
|
| Now if your partner brings the topic up to you and mentions
| health issues they're experiencing then sure, it's fine to
| offer your view, but that's not how it sounds to us
| reading.
| blindriver wrote:
| [flagged]
| ziziyO wrote:
| > One of my girlfriends actually got mad
|
| Am surprised only one did.
| sacrosancty wrote:
| [flagged]
| phnofive wrote:
| Taking this at face value, I don't think so - but it has been
| linked with cervical and uterine cancers.
| AiaAidan wrote:
| [flagged]
| fsckboy wrote:
| i suppose by "permanent birth control" you mean sterilizing
| onesself? i can't stand euphemisms, like "reproductive freedom"
| means terminating reproductees with extreme prejudice (i had to
| use a euphemism for that or half the people here would freak
| out)
|
| (in this debate, I'm on the side of Huxley and Orwell, and
| against Hitler, Mao and Stalin. which side are you guys on?)
| emodendroket wrote:
| So you'd prefer we use dysphemisms that support your view of
| it instead.
| fsckboy wrote:
| sterilization isn't my view, it's what it is. permanent
| birth control could include suicide, it's ambiguous.
|
| the only reason one would avoid what you are terming
| dysphemisms is if you are advocating that people do more of
| something and you wish to hide what it is.
| emodendroket wrote:
| Calling abortion (which is only one element of what is
| meant by "reproductive freedom") "terminating
| reproductees with extreme prejudice" is a dysphemism by
| any reasonable standard.
| asmor wrote:
| Okay ChatGPT.
| [deleted]
| fnordpiglet wrote:
| After I had the kids I wanted, I got a vasectomy. It's a painless
| and quick and largely reversible procedure with no side effects
| and offers 100% contraception. If you care about your partner and
| are "done," I highly recommend it.
| emodendroket wrote:
| That's all well and good but there are a lot of situations
| where women go for birth control where that isn't much of an
| option.
| fnordpiglet wrote:
| I certainly didn't say anything to preclude that. In fact
| unless the woman is certain of the man, she should control
| her own contraception. The consequence of a mistake falls
| disproportionately on her and, well, men are pretty much all
| assholes, even the well intentioned ones. My message, though,
| was for men - not for women. Vasectomies are a man's choice,
| and the only one we can make that fully insulates the woman
| in our life from the consequences of sex. Any other measure a
| man can take is pretty poor in it's effectiveness.
| gnicholas wrote:
| A few of my friends have looked into this and decided against
| because it is actually not as reversible as they initially
| thought.
|
| What did your doctor tell you about reversibility?
| AiaAidan wrote:
| Thanks for sharing your positive experience - it's great to
| hear that the procedure was painless and quick, and has given
| you and your partner a reliable form of contraception. More
| important, having a close person in your life whom you can
| trust is truly a life jackpot! In the current "epidemic of
| loneliness," it's more important than ever to have strong
| personal connections.
| jawns wrote:
| Not quite 100%.
|
| > The early failure rate of vasectomy (presence of motile sperm
| in the ejaculate at 3-6 months post-vasectomy) is in the range
| of 0.3-9% and the late failure rate is in the range of
| 0.04-0.08%.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110415/
|
| 8 out of 10,000 men is still a very low failure rate, although
| keep in mind that typically failure rates for
| contraceptives/sterilization are per annum.
|
| So if you get a vasectomy with a 0.08% failure rate and then
| have sex for 30 years ... 0.08% * 30 = 2.4%.
| HDMI_Cable wrote:
| To be fair, that's still a better 30-year failure rate than
| most contraceptives:
|
| Typical hormonal IUD annual failure rate = .1% [1].
|
| .1% * 30 years = 3%.
|
| Considering that one would have to get the hormonal IUD
| replaced (painful!!) every 3-8 years [1], while vasectomies
| only require check-ups two times after the procedure (not
| painful) after 1-2 months, and at one's discretion
| afterwards, that's a way better value proposition.
| yamrzou wrote:
| The title is misleading. It should be:
|
| Any type of hormonal contraceptive _is associated_ with an
| increased risk of breast cancer.
| LorenPechtel wrote:
| Yeah--there's a factor here that messes up the data. Namely,
| that pregnancy to term is associated with a *reduction* in
| breast cancer, the earlier the pregnancy the bigger the effect.
|
| This is the reason behind the "pro-life" claim that abortion
| causes breast cancer--no, it simply doesn't provide the
| protection. Never-pregnant vs had-abortion is the same risk.
| Hormonal contraception is more effective and will reduce the
| oops rate and thus would be expected to show a positive
| correlation with breast cancer.
|
| (And the oops rate is also why for a young non-smoker the risk
| of the pill is *negative* even if the response to an oops is an
| immediate abortion. Carrying it to term increases the effect by
| at least an order of magnitude.)
| yamrzou wrote:
| I think that factor is taken into account here:
|
| > These calculations were then adjusted to take into account
| established risk factors such as body mass index (BMI),
| _number of recorded births, and the time since a woman's last
| birth_.
|
| Is it the same one?
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(page generated 2023-03-25 23:01 UTC)