The epidemiology of oral contraceptive use: A critical review of the studies on oral contraceptives and the health of young women

The epidemiology of oral contraceptive use: A critical review of the studies on oral... Recent observational studies show a slightly increased risk of venous thromboembolism among users of newer combined oral contraceptives with odds ratios between 0.8 and 2.3 when compared with users of older oral contraceptives. The controversy regarding the newer oral contraceptives is reviewed by analyzing the recent studies with epidemiologic methods. Key studies on venous thromboembolism may be subject to bias related to prescribing criteria, diagnostics, hospital referral, cohort effects, and residual confounding, resulting in an overestimate of the risk of venous thromboembolism associated with the newer oral contraceptives. The studies on stroke showed no difference between newer and older oral contraceptives, and studies on myocardial infarction show that newer oral contraceptives carry no risk of this event. Newer-generation oral contraceptives are unlikely to constitute a significant hazard to the user population with regard to venous thromboembolism. The results for other disease entities also need to be taken into account when the results on venous thromboembolism are assessed on a population basis. (Am J Obstet Gynecol 1998;179:1086-97.) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Obstetrics and Gynecology Wolters Kluwer Health

The epidemiology of oral contraceptive use: A critical review of the studies on oral contraceptives and the health of young women

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Publisher
Wolters Kluwer Health
Copyright
Copyright © 1998 Mosby, Inc.
ISSN
0002-9378
DOI
10.1016/S0002-9378(98)70220-0
Publisher site
See Article on Publisher Site

Abstract

Recent observational studies show a slightly increased risk of venous thromboembolism among users of newer combined oral contraceptives with odds ratios between 0.8 and 2.3 when compared with users of older oral contraceptives. The controversy regarding the newer oral contraceptives is reviewed by analyzing the recent studies with epidemiologic methods. Key studies on venous thromboembolism may be subject to bias related to prescribing criteria, diagnostics, hospital referral, cohort effects, and residual confounding, resulting in an overestimate of the risk of venous thromboembolism associated with the newer oral contraceptives. The studies on stroke showed no difference between newer and older oral contraceptives, and studies on myocardial infarction show that newer oral contraceptives carry no risk of this event. Newer-generation oral contraceptives are unlikely to constitute a significant hazard to the user population with regard to venous thromboembolism. The results for other disease entities also need to be taken into account when the results on venous thromboembolism are assessed on a population basis. (Am J Obstet Gynecol 1998;179:1086-97.)

Journal

American Journal of Obstetrics and GynecologyWolters Kluwer Health

Published: Oct 1, 1998

References

  • Causal inference in epidemiology
    Rothman, KJ.
  • Rebuilding confidence in oral contraceptives: a new imperative in family planning
    Spitzer, WO.
  • Oral contraceptives and thrombotic diseases: impact of new epidemiological studies
    Lidegaard, O; Milsom, I.
  • Selective prescribing of third generation oral contraceptives (OCs)
    Jamin, C; de Mouzon, J.
  • Utilization patterns of oral contraceptives in UK general practice
    Farmer, RDT; Lawrenson, R.
  • Oral contraceptives and thrombotic diseases: impact of new epidemiological studies
    Farley, TMM; Meirik, O; Poulter, NR; Chang, CL; Marmot, MG.
  • The increased risk of venous thromboembolism and the use of third generation progestagens: role of bias in observational research
    Lewis, MA; Heinemann, LAJ; MacRae, KD; Bruppacher, R; Spitzer, WO.
  • Increased number of induced abortions in Norway after media coverage of adverse vascular events from the use of third-generation oral contraceptives
    Skjeldestad, FE.
  • First-time use of newer oral contraceptives and the risk of venous thromboembolism
    Suissa, S; Blais, L; Spitzer, WO; Cusson, J; Lewis, M; Heinemann, L.

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