A systematic review and meta‐analysis of venous thrombosis risk among users of combined oral contraception

Details

• Alternative Title:
  Int J Gynaecol Obstet
• Personal Author:
  Dragoman, Monica V. ; Tepper, Naomi K. ; Fu, Rongwei ; Curtis, Kathryn M. ; Chou, Roger ; Gaffield, Mary E.
• Description:
  Background
  
  Combined oral contraceptives (COCs) containing various progestogens could be associated with differential risks for venous thromboembolism (VTE).
  
  Objective
  
  To evaluate the comparative risks of VTE associated with the use of low‐dose (less than 50 μg ethinyl estradiol) COCs containing different progestogens.
  
  Search strategy
  
  PubMed and the Cochrane Library were searched from database inception through September 15, 2016, by combining search terms for oral contraception and venous thrombosis.
  
  Selection criteria
  
  Studies reporting VTE risk estimates among healthy users of progestogen‐containing low‐dose COCs were included.
  
  Data collection and analysis
  
  A random‐effects model was used to generate pooled adjusted risk ratios and 95% confidence intervals; subgroup and sensitivity analyses assessed the impact of monophasic‐COC use and study‐level characteristics.
  
  Main results
  
  There were 22 articles included in the analysis. The use of COCs containing cyproterone acetate, desogestrel, drospirenone, or gestodene was associated with a significantly increased risk of VTE compared with the use of levonorgestrel‐containing COCs (pooled risk ratios 1.5–2.0). The analysis restricted to monophasic COC formulations with 30 μg of ethinyl estradiol yielded similar findings. After adjustment for study characteristics, the risk estimates were slightly attenuated.
  
  Conclusions
  
  Compared with the use of levonorgestrel‐containing COCs, the use of COCs containing other progestogens could be associated with a small increase in risk for VTE.
  
  
• Subjects:
  Contraceptives, Oral, Combined Female Humans Odds Ratio Progestins Risk Venous Thromboembolism Venous Thrombosis
• Source:
  Int J Gynaecol Obstet. 141(3):287-294.
• Pubmed ID:
  29388678
• Pubmed Central ID:
  PMC5969307
• Document Type:
  Journal Article
• Funding:
  001/World Health Organization/International
• Volume:
  141
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2463906b57dfa3d092574c19f139d4bf47cc8eecdffc251dd0f2a4ee490fb66a
• Download URL:
  https://stacks.cdc.gov/view/cdc/56528/cdc_56528_DS1.pdf
• File Type:
  [PDF - 772.30 KB ]