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

Affiliations
  • 1Gastroenterology and Liver Services, Concord Repatriation General Hospital, Concord NSW, Australia. rupertleong@outlook.com
  • 2Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Hong Kong, China.
  • 3Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
  • 4The First Affiliated Hospital of Sun Yat Sen University, Guangzhou, China.
  • 5Xijing Hospital, Fourth Military Medical University, Xian, China.
  • 6King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
  • 7Hospital Conde S Januario, Macau, China.
  • 8National University Hospital of Singapore, Singapore.
  • 9West China Hospital, Sichuan University, Chengdu, China.
  • 10University of Malaya Medical Center, Kuala Lumpur, Malaysia.
  • 11University of Indonesia, Indonesia.
  • 12Maharaj Nakorn Chiangmai Hospital, Chiangmai, Thailand.

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
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