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First-time use of newer oral contraceptives and the risk of venous thromboembolism.
Contraception. 1997 Sep; 56(3):141-6.C

Abstract

Recent epidemiologic studies reported that the risk of venous thromboembolism (VTE) was higher with the use of the newer third generation oral contraceptives than with second generation agents. Although the overall findings of these studies are similar, the results, as they relate to patterns and duration of oral contraceptive use particularly among first-time users, are inconsistent. We reanalyzed data from the Transnational case-control study to assess the risk of VTE associated with first-time use of oral contraceptives as a function of its duration of use. Over the period 1993 to 1995, 471 cases of venous thromboembolism were identified in Germany and the United Kingdom. For each case, up to four controls were obtained, for a total of 1772 controls. Data on oral contraceptive use and confounding variables, including data on sociodemographic, lifestyle, medical history, and family history of disease, were obtained by interview. Data analysis was based on the 105 cases and 422 controls who were first-time users of second or third generation agents, or never users of oral contraception. Rate ratios, adjusted for confounders and approximated by odds ratios, were estimated as a continuous function of duration of oral contraceptive use by logistic regression and quadratic spline models. We found, for first-time users, that the adjusted rate ratio of VTE as a function of the duration of oral contraceptive use is essentially identical for second and third generation pills relative to never users. This rate ratio increases to around 10 in the first year of use and decreases to around two after 2 years of use, remaining at this risk level thereafter for both second and third generation agents. We conclude that second and third generation agents are associated with identical risks of venous thromboembolism when they are prescribed to women who are using oral contraceptives for the first time ever.

Authors+Show Affiliations

Division of Clinical Epidemiology, Royal Victoria Hospital, Montréal, Québec, Canada. SAMYS@EPID.LAN.MCGILL.CANo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9347203

Citation

Suissa, S, et al. "First-time Use of Newer Oral Contraceptives and the Risk of Venous Thromboembolism." Contraception, vol. 56, no. 3, 1997, pp. 141-6.
Suissa S, Blais L, Spitzer WO, et al. First-time use of newer oral contraceptives and the risk of venous thromboembolism. Contraception. 1997;56(3):141-6.
Suissa, S., Blais, L., Spitzer, W. O., Cusson, J., Lewis, M., & Heinemann, L. (1997). First-time use of newer oral contraceptives and the risk of venous thromboembolism. Contraception, 56(3), 141-6.
Suissa S, et al. First-time Use of Newer Oral Contraceptives and the Risk of Venous Thromboembolism. Contraception. 1997;56(3):141-6. PubMed PMID: 9347203.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - First-time use of newer oral contraceptives and the risk of venous thromboembolism. AU - Suissa,S, AU - Blais,L, AU - Spitzer,W O, AU - Cusson,J, AU - Lewis,M, AU - Heinemann,L, PY - 1997/11/5/pubmed PY - 1997/11/5/medline PY - 1997/11/5/entrez KW - Acceptors KW - Acceptors, New KW - Biology KW - Case Control Studies KW - Contraception KW - Contraceptive Methods--side effects KW - Developed Countries KW - Diseases KW - Embolism KW - Europe KW - Family Planning KW - Family Planning Programs KW - Germany KW - Northern Europe KW - Oral Contraceptives, Combined--side effects KW - Oral Contraceptives, Low-dose--side effects KW - Oral Contraceptives--side effects KW - Research Methodology KW - Research Report KW - Risk Factors KW - Studies KW - Thromboembolism KW - United Kingdom KW - Vascular Diseases KW - Western Europe SP - 141 EP - 6 JF - Contraception JO - Contraception VL - 56 IS - 3 N2 - Recent epidemiologic studies reported that the risk of venous thromboembolism (VTE) was higher with the use of the newer third generation oral contraceptives than with second generation agents. Although the overall findings of these studies are similar, the results, as they relate to patterns and duration of oral contraceptive use particularly among first-time users, are inconsistent. We reanalyzed data from the Transnational case-control study to assess the risk of VTE associated with first-time use of oral contraceptives as a function of its duration of use. Over the period 1993 to 1995, 471 cases of venous thromboembolism were identified in Germany and the United Kingdom. For each case, up to four controls were obtained, for a total of 1772 controls. Data on oral contraceptive use and confounding variables, including data on sociodemographic, lifestyle, medical history, and family history of disease, were obtained by interview. Data analysis was based on the 105 cases and 422 controls who were first-time users of second or third generation agents, or never users of oral contraception. Rate ratios, adjusted for confounders and approximated by odds ratios, were estimated as a continuous function of duration of oral contraceptive use by logistic regression and quadratic spline models. We found, for first-time users, that the adjusted rate ratio of VTE as a function of the duration of oral contraceptive use is essentially identical for second and third generation pills relative to never users. This rate ratio increases to around 10 in the first year of use and decreases to around two after 2 years of use, remaining at this risk level thereafter for both second and third generation agents. We conclude that second and third generation agents are associated with identical risks of venous thromboembolism when they are prescribed to women who are using oral contraceptives for the first time ever. SN - 0010-7824 UR - https://www.unboundmedicine.com/medline/citation/9347203/First_time_use_of_newer_oral_contraceptives_and_the_risk_of_venous_thromboembolism_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0010782497001194 DB - PRIME DP - Unbound Medicine ER -