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Pubertal development after unintended intrauterine exposure to oral contraceptives: a nationwide cohort study.

Abstract

OBJECTIVE

To study the associations between exposure to oral contraceptives before conception and early in pregnancy and pubertal timing in boys and girls.

DESIGN

Population-based cohort study.

SETTING

Not applicable.

PATIENT(S)

Overall, 15,800 children (70%) born during 2000-2003 into the Danish National Birth Cohort were categorized according to maternal use of combined oral contraceptive pills or progestin-only pills reported around gestational week 17: no exposure (reference), exposure 4 months before conception, and exposure in early pregnancy. Children self-assessed pubertal status using Web-based questionnaires from 11 years and biannually throughout puberty.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Adjusted mean age differences (months) for attaining individual pubertal milestones and overall pubertal timing. Proportion mediated by prepubertal body mass index.

RESULT(S)

In boys, intrauterine exposure to oral contraceptives showed a tendency toward slightly earlier mean age for voice break (months, -3.8; 95% confidence interval [CI] -6.5, -1.0) and first ejaculation (months, -2.9; 95% CI -5.9, 0.1) and a mean difference of -1.4 months (95% CI -3.3, 0.4) for overall pubertal timing. Girls with intrauterine exposure tended to have slightly earlier age at menarche (months, -1.9; 95% CI -4.0, 0.3) and Tanner breast stages and had a mean difference of -0.9 months (95% CI -2.7, 1.0) for overall pubertal timing. Exposure before conception was not associated with pubertal timing. Prepubertal body mass index did not play a mediating role.

CONCLUSION(S)

This study shows some evidence that intrauterine exposure to oral contraceptives might slightly affect pubertal timing.

Authors+Show Affiliations

Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California. Electronic address: and_ernst@outlook.com.Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California.Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California; Department of Statistics, UCLA College of Letters and Science, Los Angeles, California; Center for Health Policy Research, UCLA, Los Angeles, California.Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.Section for Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark.Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.Section for Paediatric Urology, Department of Urology, Aarhus University Hospital, Aarhus, Denmark.Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31311623

Citation

Ernst, Andreas, et al. "Pubertal Development After Unintended Intrauterine Exposure to Oral Contraceptives: a Nationwide Cohort Study." Fertility and Sterility, 2019.
Ernst A, Lauridsen LLB, Brix N, et al. Pubertal development after unintended intrauterine exposure to oral contraceptives: a nationwide cohort study. Fertil Steril. 2019.
Ernst, A., Lauridsen, L. L. B., Brix, N., Arah, O. A., Olsen, J., Parner, E. T., ... Ramlau-Hansen, C. H. (2019). Pubertal development after unintended intrauterine exposure to oral contraceptives: a nationwide cohort study. Fertility and Sterility, doi:10.1016/j.fertnstert.2019.05.011.
Ernst A, et al. Pubertal Development After Unintended Intrauterine Exposure to Oral Contraceptives: a Nationwide Cohort Study. Fertil Steril. 2019 Jul 13; PubMed PMID: 31311623.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pubertal development after unintended intrauterine exposure to oral contraceptives: a nationwide cohort study. AU - Ernst,Andreas, AU - Lauridsen,Lea L B, AU - Brix,Nis, AU - Arah,Onyebuchi A, AU - Olsen,Jørn, AU - Parner,Erik T, AU - Nybo Andersen,Anne-Marie, AU - Olsen,Lars H, AU - Ramlau-Hansen,Cecilia H, Y1 - 2019/07/13/ PY - 2019/01/08/received PY - 2019/04/06/revised PY - 2019/05/07/accepted PY - 2019/7/18/entrez KW - Adolescent KW - drug safety KW - epidemiology KW - oral contraceptives KW - pubertal development JF - Fertility and sterility JO - Fertil. Steril. N2 - OBJECTIVE: To study the associations between exposure to oral contraceptives before conception and early in pregnancy and pubertal timing in boys and girls. DESIGN: Population-based cohort study. SETTING: Not applicable. PATIENT(S): Overall, 15,800 children (70%) born during 2000-2003 into the Danish National Birth Cohort were categorized according to maternal use of combined oral contraceptive pills or progestin-only pills reported around gestational week 17: no exposure (reference), exposure 4 months before conception, and exposure in early pregnancy. Children self-assessed pubertal status using Web-based questionnaires from 11 years and biannually throughout puberty. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Adjusted mean age differences (months) for attaining individual pubertal milestones and overall pubertal timing. Proportion mediated by prepubertal body mass index. RESULT(S): In boys, intrauterine exposure to oral contraceptives showed a tendency toward slightly earlier mean age for voice break (months, -3.8; 95% confidence interval [CI] -6.5, -1.0) and first ejaculation (months, -2.9; 95% CI -5.9, 0.1) and a mean difference of -1.4 months (95% CI -3.3, 0.4) for overall pubertal timing. Girls with intrauterine exposure tended to have slightly earlier age at menarche (months, -1.9; 95% CI -4.0, 0.3) and Tanner breast stages and had a mean difference of -0.9 months (95% CI -2.7, 1.0) for overall pubertal timing. Exposure before conception was not associated with pubertal timing. Prepubertal body mass index did not play a mediating role. CONCLUSION(S): This study shows some evidence that intrauterine exposure to oral contraceptives might slightly affect pubertal timing. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/31311623/Pubertal_development_after_unintended_intrauterine_exposure_to_oral_contraceptives:_a_nationwide_cohort_study L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(19)30435-2 DB - PRIME DP - Unbound Medicine ER -