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The association between new generation oral contraceptive pill and the development of inflammatory bowel diseases

Sanagapalli S 1 , Ko Y 1 , Kariyawasam V 1 , Ng SC 2 , Tang W 2 , de Silva HJ 3 Show all authors , Chen M 4 , Wu K 5 , Aniwan S 6 , Ng KK 7 , Ong D 8 , Ouyang Q 9 , Hilmi I 10 , Simadibrata M 11 , Pisespongsa P 12 , Gopikrishna S 1 , Leong RW 1 , IBD Sydney Organisation and the Asia-Pacific Crohn's and Colitis Epidemiology Study (ACCESS) Group

Affiliations 

  • 1 Gastroenterology and Liver Services, Concord Repatriation General Hospital, Concord NSW, Australia
  • 2 Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Hong Kong, China
  • 3 Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
  • 4 The First Affiliated Hospital of Sun Yat Sen University, Guangzhou, China
  • 5 Xijing Hospital, Fourth Military Medical University, Xian, China
  • 6 King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • 7 Hospital Conde S Januario, Macau, China
  • 8 National University Hospital of Singapore, Singapore
  • 9 West China Hospital, Sichuan University, Chengdu, China
  • 10 University of Malaya Medical Center, Kuala Lumpur, Malaysia
  • 11 University of Indonesia, Indonesia
  • 12 Maharaj Nakorn Chiangmai Hospital, Chiangmai, Thailand
Intest Res, 2018 Jul;16(3):409-415.
PMID: 30090040 DOI: 10.5217/ir.2018.16.3.409

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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