This article is more than 5 years old. Information may no longer be current.
Oral contraceptive use associated with increased risk for Crohn's disease
Click Here to Manage Email Alerts
Women who use oral contraceptives may be at increased risk for Crohn’s disease, and those with a history of smoking may have an additional risk for ulcerative colitis, according to recent results.
In a prospective cohort study, researchers evaluated data from 232,452 US female registered nurses enrolled in two studies started in 1976 and 1989. No participants had a history of ulcerative colitis (UC) or Crohn’s disease (CD). During the two studies, participants responded biennially to questionnaires that included demographics, use of oral contraceptives, giving birth and menopausal status, and other risk factors.
Across all participants and more than 5 million person-years of follow-up, 315 new incidents of CD and 392 of UC were reported. After adjusting for other CD risk factors, investigators calculated an HR of 2.82 (95% CI, 1.65-4.82) for CD risk among current oral contraceptive users and an HR of 1.39 (95% CI, 1.05-1.85) among past users. No other reproductive factors (age at menarche, age at first birth and parity) were found to increase the risks for CD or UC.
Past and current contraceptive users were found to be at higher risk for UC than nonusers, but the association was not found statistically significant (adjusted HR=1.22; 95% CI, 0.74-2.07 for current users and adjusted HR=1.18; 95% CI, 0.91-1.52 for past users). However, investigators found that women with a history of smoking were at a significantly increased risk for UC (Pinteraction=.04). After adjusting for other factors, an HR of 1.63 (95% CI, 1.13-2.35) was calculated for smokers who used oral contraceptives, compared with an HR of 0.86 (95% CI, 0.61-1.21) for nonsmokers. Risk for CD was not significantly impacted by smoking status (Pinteraction=.72).
“Our findings shed light on new and potentially diverging biological pathways involved in pathogenesis of CD and UC,” the researchers wrote. “In addition, our data suggest the importance of carefully evaluating contraceptive options among women who may be at higher risk of CD or UC.”
Click Here to Manage Email Alerts