A systematic review and meta‐analysis of venous thrombosis risk among users of combined oral contraception

International Journal of Gynecology & Obstetrics - Tập 141 Số 3 - Trang 287-294 - 2018
Monica Dragoman1, Naomi K. Tepper2, Rongwei Fu3, Kathryn M. Curtis2, Roger Chou3, Mary E. Gaffield1
1Department of Reproductive Health and Research, WHO, Geneva, Switzerland
2Division of Reproductive Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
3Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA

Tóm tắt

AbstractBackgroundCombined oral contraceptives (COCs) containing various progestogens could be associated with differential risks for venous thromboembolism (VTE).ObjectiveTo evaluate the comparative risks of VTE associated with the use of low‐dose (less than 50 μg ethinyl estradiol) COCs containing different progestogens.Search strategyPubMed and the Cochrane Library were searched from database inception through September 15, 2016, by combining search terms for oral contraception and venous thrombosis.Selection criteriaStudies reporting VTE risk estimates among healthy users of progestogen‐containing low‐dose COCs were included.Data collection and analysisA random‐effects model was used to generate pooled adjusted risk ratios and 95% confidence intervals; subgroup and sensitivity analyses assessed the impact of monophasic‐COC use and study‐level characteristics.Main resultsThere were 22 articles included in the analysis. The use of COCs containing cyproterone acetate, desogestrel, drospirenone, or gestodene was associated with a significantly increased risk of VTE compared with the use of levonorgestrel‐containing COCs (pooled risk ratios 1.5–2.0). The analysis restricted to monophasic COC formulations with 30 μg of ethinyl estradiol yielded similar findings. After adjustment for study characteristics, the risk estimates were slightly attenuated.ConclusionsCompared with the use of levonorgestrel‐containing COCs, the use of COCs containing other progestogens could be associated with a small increase in risk for VTE.

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International Journal of Gynecology & Obstetrics

Tập 141 Số 3

287-294

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