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Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10

Objective To assess the risk of venous thrombosis in current users of non-oral hormonal contraception. Design Historical national registry based cohort study. Setting Four national registries in Denmark. Participants All Danish non-pregnant women aged 15-49 (n=1 626 158), free of previous thrombotic...

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Autores principales: Lidegaard, Øjvind, Nielsen, Lars Hougaard, Skovlund, Charlotte Wessel, Løkkegaard, Ellen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349780/
https://www.ncbi.nlm.nih.gov/pubmed/22577198
http://dx.doi.org/10.1136/bmj.e2990
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author Lidegaard, Øjvind
Nielsen, Lars Hougaard
Skovlund, Charlotte Wessel
Løkkegaard, Ellen
author_facet Lidegaard, Øjvind
Nielsen, Lars Hougaard
Skovlund, Charlotte Wessel
Løkkegaard, Ellen
author_sort Lidegaard, Øjvind
collection PubMed
description Objective To assess the risk of venous thrombosis in current users of non-oral hormonal contraception. Design Historical national registry based cohort study. Setting Four national registries in Denmark. Participants All Danish non-pregnant women aged 15-49 (n=1 626 158), free of previous thrombotic disease or cancer, were followed from 2001 to 2010. Main outcome measures Incidence rate of venous thrombosis in users of transdermal, vaginal, intrauterine, or subcutaneous hormonal contraception, relative risk of venous thrombosis compared with non-users, and rate ratios of venous thrombosis in current users of non-oral products compared with the standard reference oral contraceptive with levonorgestrel and 30-40 µg oestrogen. Diagnoses were confirmed by at least four weeks of anticoagulation therapy after the diagnosis. Results Within 9 429 128 woman years of observation, 5287 first ever venous thrombosis events were recorded, of which 3434 were confirmed. In non-users of hormonal contraception the incidence rate of confirmed events was 2.1 per 10 000 woman years. Compared with non-users of hormonal contraception, and after adjustment for age, calendar year, and education, the relative risk of confirmed venous thrombosis in users of transdermal combined contraceptive patches was 7.9 (95% confidence interval 3.5 to 17.7) and of the vaginal ring was 6.5 (4.7 to 8.9). The corresponding incidences per 10 000 exposure years were 9.7 and 7.8 events. The relative risk was increased in women who used subcutaneous implants (1.4, 0.6 to 3.4) but not in those who used the levonorgestrel intrauterine system (0.6, 0.4 to 0.8). Compared with users of combined oral contraceptives containing levonorgestrel, the adjusted relative risk of venous thrombosis in users of transdermal patches was 2.3 (1.0 to 5.2) and of the vaginal ring was 1.9 (1.3 to 2.7). Conclusion Women who use transdermal patches or vaginal rings for contraception have a 7.9 and 6.5 times increased risk of confirmed venous thrombosis compared with non-users of hormonal contraception of the same age, corresponding to 9.7 and 7.8 events per 10 000 exposure years. The risk was slightly increased in women using subcutaneous implants but not in those using the levonorgestrel intrauterine system.
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spelling pubmed-33497802012-05-10 Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10 Lidegaard, Øjvind Nielsen, Lars Hougaard Skovlund, Charlotte Wessel Løkkegaard, Ellen BMJ Research Objective To assess the risk of venous thrombosis in current users of non-oral hormonal contraception. Design Historical national registry based cohort study. Setting Four national registries in Denmark. Participants All Danish non-pregnant women aged 15-49 (n=1 626 158), free of previous thrombotic disease or cancer, were followed from 2001 to 2010. Main outcome measures Incidence rate of venous thrombosis in users of transdermal, vaginal, intrauterine, or subcutaneous hormonal contraception, relative risk of venous thrombosis compared with non-users, and rate ratios of venous thrombosis in current users of non-oral products compared with the standard reference oral contraceptive with levonorgestrel and 30-40 µg oestrogen. Diagnoses were confirmed by at least four weeks of anticoagulation therapy after the diagnosis. Results Within 9 429 128 woman years of observation, 5287 first ever venous thrombosis events were recorded, of which 3434 were confirmed. In non-users of hormonal contraception the incidence rate of confirmed events was 2.1 per 10 000 woman years. Compared with non-users of hormonal contraception, and after adjustment for age, calendar year, and education, the relative risk of confirmed venous thrombosis in users of transdermal combined contraceptive patches was 7.9 (95% confidence interval 3.5 to 17.7) and of the vaginal ring was 6.5 (4.7 to 8.9). The corresponding incidences per 10 000 exposure years were 9.7 and 7.8 events. The relative risk was increased in women who used subcutaneous implants (1.4, 0.6 to 3.4) but not in those who used the levonorgestrel intrauterine system (0.6, 0.4 to 0.8). Compared with users of combined oral contraceptives containing levonorgestrel, the adjusted relative risk of venous thrombosis in users of transdermal patches was 2.3 (1.0 to 5.2) and of the vaginal ring was 1.9 (1.3 to 2.7). Conclusion Women who use transdermal patches or vaginal rings for contraception have a 7.9 and 6.5 times increased risk of confirmed venous thrombosis compared with non-users of hormonal contraception of the same age, corresponding to 9.7 and 7.8 events per 10 000 exposure years. The risk was slightly increased in women using subcutaneous implants but not in those using the levonorgestrel intrauterine system. BMJ Publishing Group Ltd. 2012-05-10 /pmc/articles/PMC3349780/ /pubmed/22577198 http://dx.doi.org/10.1136/bmj.e2990 Text en © Lidegaard et al 2012 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
spellingShingle Research
Lidegaard, Øjvind
Nielsen, Lars Hougaard
Skovlund, Charlotte Wessel
Løkkegaard, Ellen
Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10
title Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10
title_full Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10
title_fullStr Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10
title_full_unstemmed Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10
title_short Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10
title_sort venous thrombosis in users of non-oral hormonal contraception: follow-up study, denmark 2001-10
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349780/
https://www.ncbi.nlm.nih.gov/pubmed/22577198
http://dx.doi.org/10.1136/bmj.e2990
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