{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:59:03Z","timestamp":1787162343891,"version":"build-2736575974"},"reference-count":45,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T00:00:00Z","timestamp":1608681600000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,12,2]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In this study, we aimed to assess the association between combined oral contraceptive (OC) use and overweight\/obesity among Ethiopian adult women of reproductive age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>The data were extracted from the 2016 Ethiopia Demographic and Health Survey; these data were collected from nine regions and two city administrations. We analysed the data from a total of 11\u2009018 women aged 18\u201349 years who met eligibility criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>We employed WHO criteria to classify the body mass index of women. Specifically we tested the association between combined OC utilisation with overweight\/obesity after controlling for confounding variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>The prevalence of combined OC utilisation was 1.7% and the prevalence of overweight\/obesity was 8.6% among adult women of reproductive age. Use of combined OC increases the odds of overweight\/obesity by two times among adult women of reproductive age after controlling for potential confounders (adjusted OR=1.902 (1.064\u20133.399)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion there is significant association between combined OC use and overweight\/obesity. The findings have important implications for policymakers to design evidence based policy approachs to obesity prevention for women and at large for government to recognise the negative consequences of combined OC on women health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-039229","type":"journal-article","created":{"date-parts":[[2020,12,24]],"date-time":"2020-12-24T11:32:31Z","timestamp":1608809551000},"page":"e039229","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["The association between combined oral contraceptive use and overweight\/obesity: a secondary data analysis of the 2016 Ethiopia Demographic and Health Survey"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1505-2500","authenticated-orcid":false,"given":"Melese Linger","family":"Endalifer","sequence":"first","affiliation":[{"name":"Department of Public Health, College Of Health Science, Woldia University, Woldia, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8616-0034","authenticated-orcid":false,"given":"Gedefaw","family":"Diress Alen","sequence":"additional","affiliation":[{"name":"Department of Public Health, College Of Health Science, Woldia University, Woldia, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3043-1816","authenticated-orcid":false,"given":"Amanuel","family":"Addisu","sequence":"additional","affiliation":[{"name":"Department of Public Health, College Of Health Science, Woldia University, Woldia, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bedilu","family":"Linger","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, College Of Medicine and Health Science, Wollo University, Dessie, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,24]]},"reference":[{"key":"2025121603001099000_10.12.e039229.1","unstructured":"WHO . Obesity and overweight factsheet, 2020."},{"key":"2025121603001099000_10.12.e039229.2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303326"},{"key":"2025121603001099000_10.12.e039229.3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0535"},{"key":"2025121603001099000_10.12.e039229.4","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1002\/2327-6924.12510","article-title":"Obesity: risk factors, complications, and strategies for sustainable long-term weight management","volume":"29","author":"Fruh","year":"2017","journal-title":"J Am Assoc Nurse Pract"},{"key":"2025121603001099000_10.12.e039229.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60460-8"},{"key":"2025121603001099000_10.12.e039229.6","doi-asserted-by":"crossref","unstructured":"Ne al . Overweight and obesity among women: analysis of demographic and health survey data from 32 sub-Saharan African countries (2016). BMC Public Health 2016;16.","DOI":"10.1186\/s12889-016-2698-5"},{"key":"2025121603001099000_10.12.e039229.7","doi-asserted-by":"publisher","DOI":"10.1159\/000471488"},{"key":"2025121603001099000_10.12.e039229.8","doi-asserted-by":"crossref","unstructured":"Angeliki A , Dimitrios P , Chara T . Maternal obesity and its association with the mode of delivery and the neonatal outcome in induced labour: implications for midwifery practice. Europ J Midwif 2018;2.","DOI":"10.18332\/ejm\/85792"},{"key":"2025121603001099000_10.12.e039229.9","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-027273","article-title":"Cesarean delivery in Nigeria: prevalence and associated factors\u2015a population-based cross-sectional study","volume":"9","author":"Adewuyi","year":"2019","journal-title":"BMJ Open"},{"key":"2025121603001099000_10.12.e039229.10","first-page":"1913","article-title":"Determinants of cesarean section among primiparas: a comparison of classification methods","volume":"47","author":"Maroufizadeh","year":"2018","journal-title":"Iran J Public Health"},{"key":"2025121603001099000_10.12.e039229.11","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318295657f"},{"key":"2025121603001099000_10.12.e039229.12","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.00685"},{"key":"2025121603001099000_10.12.e039229.13","doi-asserted-by":"crossref","unstructured":"Sugiharti S , Hadi H , Julia M . Hormonal contraception as a risk factor for obesity. Med J Indones 2005;14.","DOI":"10.13181\/mji.v14i3.191"},{"key":"2025121603001099000_10.12.e039229.14","doi-asserted-by":"crossref","DOI":"10.5888\/pcd15.170401","article-title":"Prevalence and predictors of overweight and obesity among Kenyan women","volume":"15","author":"Mkuu","year":"2018","journal-title":"Prev Chronic Dis"},{"key":"2025121603001099000_10.12.e039229.15","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0194454","article-title":"The prevalence of underweight, overweight and obesity and their related socio-demographic and lifestyle factors among adult women in Myanmar, 2015-16","volume":"13","author":"Hong","year":"2018","journal-title":"PLoS One"},{"key":"2025121603001099000_10.12.e039229.16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0158177","article-title":"Oral contraceptive use, micronutrient deficiency, and obesity among premenopausal females in Korea: the necessity of dietary supplements and food intake improvement","volume":"11","author":"Park","year":"2016","journal-title":"PLoS One"},{"key":"2025121603001099000_10.12.e039229.17","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1038\/s41366-019-0442-9","article-title":"Oral contraceptives use and development of obesity in a Mediterranean cohort: the sun (Seguimiento Universidad de Navarra) project","volume":"44","author":"San-Juan-Rodriguez","year":"2020","journal-title":"Int J Obes"},{"key":"2025121603001099000_10.12.e039229.18","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1586\/eog.11.46","article-title":"Obesity and the combined oral contraceptive pill: efficacy and effects","volume":"6","author":"Miller","year":"2011","journal-title":"Expert Rev Obstet Gynecol"},{"key":"2025121603001099000_10.12.e039229.19","unstructured":"Healthcare FoSR. Overweight, Obesity and Contraception. In: Unit CE, editor. United Kingdom: Faculty of Sexual & Reproductive Healthcare. 2019."},{"key":"2025121603001099000_10.12.e039229.20","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.contraception.2008.11.017","article-title":"Obesity and oral contraceptive pill failure","volume":"79","author":"Trussell","year":"2009","journal-title":"Contraception"},{"key":"2025121603001099000_10.12.e039229.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2009.04.011"},{"key":"2025121603001099000_10.12.e039229.22","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.contraception.2014.06.033","article-title":"Correcting oral contraceptive pharmacokinetic alterations due to obesity: a randomized controlled trial","volume":"90","author":"Edelman","year":"2014","journal-title":"Contraception"},{"key":"2025121603001099000_10.12.e039229.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.01.016"},{"key":"2025121603001099000_10.12.e039229.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.07.1094"},{"key":"2025121603001099000_10.12.e039229.25","unstructured":"Robinson JA , Burke AE . Obesity and hormonal contraceptive efficacy, 2014."},{"key":"2025121603001099000_10.12.e039229.26","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwm221"},{"key":"2025121603001099000_10.12.e039229.27","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.contraception.2015.09.013","article-title":"Body mass index does not affect the efficacy or bleeding profile during use of an ultra-low-dose combined oral contraceptive","volume":"93","author":"Nakajima","year":"2016","journal-title":"Contraception"},{"key":"2025121603001099000_10.12.e039229.28","doi-asserted-by":"crossref","unstructured":"Lopez LM , Bernholc A , Chen M , et al . Hormonal contraceptives for contraception in overweight or obese women. Cochrane Database Syst Rev 2016;79.doi:10.1002\/14651858.CD008452.pub4","DOI":"10.1002\/14651858.CD008452.pub4"},{"key":"2025121603001099000_10.12.e039229.29","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1038\/bjc.2016.400","article-title":"Combined oral contraceptive use before the first birth and epithelial ovarian cancer risk","volume":"116","author":"Cook","year":"2017","journal-title":"Br J Cancer"},{"key":"2025121603001099000_10.12.e039229.30","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1089\/jwh.2015.5418","article-title":"Metabolic effects of a commonly used combined hormonal oral contraceptive in women with and without polycystic ovary syndrome","volume":"25","author":"Adeniji","year":"2016","journal-title":"J Womens Health"},{"key":"2025121603001099000_10.12.e039229.31","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0802713"},{"key":"2025121603001099000_10.12.e039229.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.05.091"},{"key":"2025121603001099000_10.12.e039229.33","doi-asserted-by":"crossref","first-page":"2989","DOI":"10.18203\/2320-6012.ijrms20193383","article-title":"The prevalence of obesity and the factors affecting obesity in the students of secondary education","volume":"7","author":"Gokosmanoglu","year":"2019","journal-title":"Int J Res Med Sci"},{"key":"2025121603001099000_10.12.e039229.34","doi-asserted-by":"crossref","DOI":"10.1177\/2040622319878997","article-title":"The prevalence of obesity and overweight, associated demographic and lifestyle factors, and health status in the adult population of Jeddah, Saudi Arabia","volume":"10","author":"Al-Raddadi","year":"2019","journal-title":"Ther Adv Chronic Dis"},{"key":"2025121603001099000_10.12.e039229.35","first-page":"367","article-title":"Prevalence of overweight and obesity in young adults in Uganda","volume":"10","author":"Baalwa","year":"2010","journal-title":"Afr Health Sci"},{"key":"2025121603001099000_10.12.e039229.36","doi-asserted-by":"crossref","DOI":"10.1186\/s13104-015-1590-1","article-title":"Prevalence of obesity and overweight and associated factors among financial institution workers in Accra Metropolis, Ghana: a cross sectional study","volume":"8","author":"Addo","year":"2015","journal-title":"BMC Res Notes"},{"key":"2025121603001099000_10.12.e039229.37","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1111\/jpc.14711","article-title":"Time spent watching television impacts on body mass index in youth with obesity, but only in those with shortest sleep duration","volume":"56","author":"Golshevsky","year":"2020","journal-title":"J Paediatr Child Health"},{"key":"2025121603001099000_10.12.e039229.38","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0214941","article-title":"Behavioral, contextual and biological factors associated with obesity during adolescence: a systematic review","volume":"14","author":"Narciso","year":"2019","journal-title":"PLoS One"},{"key":"2025121603001099000_10.12.e039229.39","doi-asserted-by":"crossref","DOI":"10.1186\/s41256-019-0117-z","article-title":"Prevalence and factors associated with underweight, overweight and obesity among women of reproductive age in India","volume":"4","author":"Al Kibria","year":"2019","journal-title":"Glob Health Res Policy"},{"key":"2025121603001099000_10.12.e039229.40","doi-asserted-by":"crossref","first-page":"3335","DOI":"10.1590\/1413-81232018249.29052017","article-title":"Change in overweight and obesity over a decade according to sociodemographic factors in Brazilian adolescents","volume":"24","author":"Santos","year":"2019","journal-title":"Cien Saude Colet"},{"key":"2025121603001099000_10.12.e039229.41","first-page":"281","article-title":"Relationship of social capital with overweight and obesity among female health care workers","volume":"10","author":"Firouzbakht","year":"2019","journal-title":"Caspian J Intern Med"},{"key":"2025121603001099000_10.12.e039229.42","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-034963"},{"key":"2025121603001099000_10.12.e039229.43","unstructured":"Central StatisticalAgency (CSA)[Ethiopia], ICF . Ethiopia demographic and health survey (EDHS), 2016."},{"key":"2025121603001099000_10.12.e039229.44","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0158177","article-title":"Oral contraceptive use, micronutrient deficiency, and obesity among premenopausal females in Korea: the necessity of dietary supplements and food intake improvement","volume":"11","author":"Park","year":"2016","journal-title":"PLoS One"},{"key":"2025121603001099000_10.12.e039229.45","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1097\/GRF.0000000000000047","article-title":"Obesity and contraception","volume":"57","author":"Mody","year":"2014","journal-title":"Clin Obstet Gynecol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-039229","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:00:21Z","timestamp":1765882821000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-039229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":45,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,24]]},"published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1136\/bmjopen-2020-039229"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-039229","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]}}}