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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 (Online), 2012-05, Vol.344 (may10 3), p.e2990-e2990 [Periódico revisado por pares]

England: British Medical Journal Publishing Group

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Título:
Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10
Autor: Lidegaard, Øjvind ; Nielsen, Lars Hougaard ; Skovlund, Charlotte Wessel ; Løkkegaard, Ellen
Assuntos: Adolescent ; Adult ; Anticoagulants - therapeutic use ; Birth control ; Cancer ; Contraception ; Contraceptive Agents, Female - administration & dosage ; Contraceptive Agents, Female - adverse effects ; Contraceptive Agents, Female - therapeutic use ; Contraceptive Devices, Female - adverse effects ; Contraceptive Devices, Female - statistics & numerical data ; Contraceptives, Oral, Combined - adverse effects ; Contraceptives, Oral, Combined - therapeutic use ; Contraceptives, Oral, Hormonal - adverse effects ; Contraceptives, Oral, Hormonal - therapeutic use ; Denmark - epidemiology ; Drug Implants ; Drugs: Cardiovascular System ; Drugs: Obstetrics and Gynaecology ; Epidemiologic Methods ; Epidemiologic Studies ; Female ; Health risk assessment ; Hormone replacement therapy ; Humans ; Levonorgestrel - adverse effects ; Levonorgestrel - therapeutic use ; Middle Aged ; Norgestrel - adverse effects ; Norgestrel - analogs & derivatives ; Norgestrel - therapeutic use ; Oral contraceptives ; Pregnancy ; Reproductive Medicine ; Stroke ; Thrombosis ; Transdermal Patch ; Vagina ; Venous Thromboembolism ; Venous Thrombosis - chemically induced ; Venous Thrombosis - epidemiology ; Womens health ; Young Adult
É parte de: BMJ (Online), 2012-05, Vol.344 (may10 3), p.e2990-e2990
Notas: ark:/67375/NVC-5BQ9DTTH-L
href:bmj-344-bmj-e2990.pdf
local:bmj;344/may10_3/e2990
ArticleID:lido003175
istex:D07BB9CB808EA89FF10986B0343827FAFF4B358D
Descrição: 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.
Editor: England: British Medical Journal Publishing Group
Idioma: Inglês

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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

England: British Medical Journal Publishing Group

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