Abstract | OBJECTIVE: DESIGN: Observational cohort study. SETTING: Data from the French national health insurance database linked with data from the French national hospital discharge database. PARTICIPANTS: MAIN OUTCOME MEASURES: RESULTS: The cohort generated 5 443 916 women years of oral contraceptive use, and 3253 events were observed: 1800 pulmonary embolisms (33 per 100 000 women years), 1046 ischaemic strokes (19 per 100 000 women years), and 407 myocardial infarctions (7 per 100 000 women years). After adjustment for progestogen and risk factors, the relative risks for women using low dose oestrogen (20 µg v 30-40 µg) were 0.75 (95% confidence interval 0.67 to 0.85) for pulmonary embolism, 0.82 (0.70 to 0.96) for ischaemic stroke, and 0.56 (0.39 to 0.79) for myocardial infarction. After adjustment for oestrogen dose and risk factors, desogestrel and gestodene were associated with statistically significantly higher relative risks for pulmonary embolism (2.16, 1.93 to 2.41 and 1.63, 1.34 to 1.97, respectively) compared with levonorgestrel. Levonorgestrel combined with 20 µg oestrogen was associated with a statistically significantly lower risk than levonorgestrel with 30-40 µg oestrogen for each of the three serious adverse events. CONCLUSIONS:
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Authors | Alain Weill, Marie Dalichampt, Fanny Raguideau, Philippe Ricordeau, Pierre-Olivier Blotière, Jérémie Rudant, François Alla, Mahmoud Zureik |
Journal | BMJ (Clinical research ed.)
(BMJ)
Vol. 353
Pg. i2002
(05 10 2016)
ISSN: 1756-1833 [Electronic] England |
PMID | 27164970
(Publication Type: Journal Article, Comment)
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Copyright | Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. |
Chemical References |
- Contraceptives, Oral
- Contraceptives, Oral, Combined
- Estrogens
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Topics |
- Cohort Studies
- Contraception
- Contraceptives, Oral
- Contraceptives, Oral, Combined
- Estrogens
- Female
- Humans
- Myocardial Infarction
(chemically induced)
- Pulmonary Embolism
(chemically induced)
- Risk Factors
- Stroke
(chemically induced)
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