title: Cervical ectopy and the transformation zone measured by computerized planimetry in adolescents.
abstract: OBJECTIVE
  To determine whether cervical ectopy and the transformation (T) zone were larger in adolescents using oral contraceptives (OCs) compared to depot medroxyprogesterone acetate (DMPA).
  
  
  METHODS
  Cervical photographs were taken on 91 adolescents in Baltimore, Maryland. Ectopy and T zone size were measured using computerized planimetry. Patients provided reproductive and sexual history. Correlates of ectopy and T zone size were identified by proportional odds and linear regression models, respectively.
  
  
  RESULTS
  Twenty-five women had no ectopy. Parity was independently associated with greater ectopy (OR 3.9, 95% CI 1.37-11.11). Predictors of smaller ectopy were douching (OR 0.23, 95% CI 0.09-0.65), and shorter sexual history (OR 0.20, 95% CI 0.05-0.74). Neither OC or DMPA were associated with ectopy. Predictors of greater T zone size were years since menarche (13.8 mm2/year, P = 0.003) and OCs (54.7 mm2, P = 0.05). DMPA predicted a smaller T zone (-67.0 mm2, P = 0.01).
  
  
  CONCLUSIONS
  Computerized planimetry provides standardized measurements. Douching and sexual activity may decrease ectopy through increased squamous metaplasia. Hormonal contraceptives were not associated with ectopy in adolescents. However, long-term progestin use may decrease T zone size.
authors.affiliation: Department of Epidemiology, The Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Jacobson
authors.forename: L
authors.initials: L
authors.lastname: Peralta
authors.forename: M
authors.initials: M
authors.lastname: Farmer
authors.forename: N M
authors.initials: NM
authors.lastname: Graham
authors.forename: T C
authors.initials: TC
authors.lastname: Wright
authors.forename: J
authors.initials: J
authors.lastname: Zenilman
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002584:Cervix Uteri / Q000033:anatomy & histology / Q000187:drug effects*; D003271:Contraceptive Agents, Female / Q000494:pharmacology*; D003276:Contraceptives, Oral / Q000494:pharmacology*; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D016015:Logistic Models; D017258:Medroxyprogesterone Acetate / Q000494:pharmacology*; D007507:Therapeutic Irrigation
chemical_list: D003271:Contraceptive Agents, Female; D003276:Contraceptives, Oral; D017258:Medroxyprogesterone Acetate