Associations of periconceptional oral contraceptive use with pregnancy complications and adverse birth outcomes

Abstract

Background Periconceptional use of oral contraceptives (OCs) has been reported to increase risks of pregnancy complications and adverse birth outcomes, but risks are suggested to differ depending on the timing of discontinuation, amount of oestrogen and progestin content. Methods Prospective cohort study among 6470 pregnancies included in the PRegnancy and Infant DEvelopment (PRIDE) Study in 2012–19. Exposure was defined as any reported use of OCs within 12 months pre-pregnancy or after conception. Outcomes of interest were gestational diabetes, gestational hypertension, pre-eclampsia, pre-term birth, low birthweight and small for gestational age (SGA). Multivariable Poisson regression using stabilized inverse probability weighting estimated relative risks (RRs) with 95% CIs. Results Any periconceptional OC use was associated with increased risks of pre-eclampsia (RR 1.38, 95% CI 0.99–1.93), pre-term birth (RR 1.38, 95% CI 1.09–1.75) and low birthweight (RR 1.45, 95% CI 1.10–1.92), but not with gestational hypertension (RR 1.09, 95% CI 0.91–1.31), gestational diabetes (RR 1.02, 95% CI 0.77–1.36) and SGA (RR 0.96, 95% CI 0.75–1.21). Associations with pre-eclampsia were strongest for discontinuation 0–3 months pre-pregnancy, for OCs containing ≥30 µg oestrogen and for first- or second-generation OCs. Pre-term birth and low birthweight were more likely to occur when OCs were discontinued 0–3 months pre-pregnancy, when using OCs containing <30 µg oestrogen and when using third-generation OCs. Associations with SGA were observed for OCs containing <30 µg oestrogen and for third- or fourth-generation OCs. Conclusions Periconceptional OC use, particularly those containing oestrogen, was associated with increased risks of pre-eclampsia, pre-term birth, low birthweight and SGA.

Preeclampsia and the Associated Risk Factors Among Pregnant Women in Indonesia: a Literature Review

“…When used for long periods, it can cause detrimental health symptoms [32]. The hormones estrogen and progesterone can facilitate sodium retention in the secretion, which increases the activity of the plasma in the excretion of angiotensin, which can improve the natural pressure [65]. Hormonal contraceptives are not caused by endometrial dysfunction, but they cause increased homocysteine levels in the blood, abnormal fatty blood glands and excess weight gain.…”

Reducing the Risk of Pre-Eclampsia in Women with Polycystic Ovary Syndrome Using a Combination of Pregnancy Screening, Lifestyle, and Medical Management Strategies

“…A recent large prospective cohort study showed that periconceptual OCP use (within 12 months) was associated with an increased risk of preterm birth, low birth weight, and PE (RR: 1.38, 95% CI: 0.99–1.93) [ 154 ]. The increased risk of PE was strongest when the OCP was stopped within 3 months of pregnancy.…”

Reply to Letter to the Editor in response to: Microvascular endothelial function following cessation of long‐term oral contraceptive pill use

“…Pregnancy outcomes may yield a more temporally adjacent context of the vascular milieu. OCP use within the past 12 months is associated with adverse pregnancy outcomes, where those who used OCP within 12 months of conception had elevated relative risk of pre‐eclampsia, pre‐term birth, and low birthweight compared with those who did not (Schreuder et al., 2023 ). As Kirby et al.…”