Intest Res.  2018 Jul;16(3):409-415. 10.5217/ir.2018.16.3.409.

The association between new generation oral contraceptive pill and the development of inflammatory bowel diseases

• Sanagapalli S
• Ko Y
• Kariyawasam V
• Ng SC
• Tang W
• de Silva H
• Chen M
• Wu K
• Aniwan S
• Ng KK
• Ong D
• Ouyang Q
• Hilmi I
• Simadibrata M
• Pisespongsa P
• Gopikrishna S
• Leong RW
• on behalf of the IBD Sydney Organisation and the Asia-Pacific Crohn's and Colitis Epidemiology Study (ACCESS) Group

• KMID: 2417653
• DOI: http://doi.org/10.5217/ir.2018.16.3.409

Abstract

BACKGROUND/AIMS
To examine the association between use of oral contraceptive pills (OCPs) and the risk of developing inflammatory bowel diseases (IBD), in a modern cohort.
METHODS
A prospective nested case-control study across sites in the Asia-Pacific region was conducted; involving female IBD cases and asymptomatic controls. Subjects completed a questionnaire addressing questions related to OCP use. Primary outcome was the risk of development of IBD of those exposed to OCP versus non-exposure. Secondary outcomes were development of Crohn's disease (CD) versus ulcerative colitis (UC), and whether age of first use of OCP use may be associated with risk of IBD.
RESULTS
Three hundred and forty-eight female IBD cases (41% CD, median age: 43 years) and 590 female age-matched controls were recruited. No significant association was found between OCP use and the risk of IBD (odds ratio [OR], 1.65; 95% confidence interval, 0.77-3.13; P=0.22), CD (OR, 1.55) or UC (OR, 1.01). The lack of association persisted when results were adjusted for age and smoking. IBD cases commenced OCP use at a younger age than controls (18 years vs. 20 years, P=0.049).
CONCLUSIONS
In this large cohort of subjects from the Asia-Pacific region, we found a modest but not significantly increased risk of developing IBD amongst OCP users.

Keyword

Inflammatory bowel diseases; Contraceptives, oral

MeSH Terms

Case-Control Studies
Cohort Studies
Colitis, Ulcerative
Contraceptives, Oral
Crohn Disease
Female
Humans
Inflammatory Bowel Diseases*
Prospective Studies
Smoke
Smoking
Contraceptives, Oral
Smoke

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