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Pregnancy and lactation

Session: Poster Session B

(290) Periconceptional Oral Contraceptive Use and the Risk of Spontaneous Abortion: Results From the PRIDE Study.

Tuesday, August 27, 2024
8:00 AM – 6:00 PM CEST
Location: Convention Hall II

    Co-Author(s)

  • Michael Ceulemans, PharmD, PhD

    Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium, Belgium

  • LT

    Lieve Tuitjer

    IQ Health, Radboud university medical center, the Netherlands, Netherlands

  • NR

    Nel Roeleveld

    IQ Health, Radboud university medical center, the Netherlands, Netherlands

  • MS

    Marc Spaanderman

    Department of Obstetrics & Gynecology, Radboud university medical center, the Netherlands, Netherlands

    • Presenting Author(s)

  • Marleen M.H.J. van Gelder, PhD

    Assistant Professor in Pharmacoepidemiology
    Pharmacoepidemiology and Drug Safety research group, Department of Pharmacy, University of Oslo, Norway
    Radboud university medical center
    Nijmegen, Netherlands

Background: Previous studies have been inconclusive about the association between periconceptional oral contraceptive (OC) use and the risk of spontaneous abortion (SAB). Given the widespread use of OC by women of reproductive age, the availability of reliable evidence on this topic is pivotal and relevant to a large population worldwide.

Objectives: To assess the association of periconceptional OC use with the risk of SAB (before 20 weeks of gestation), while considering the timing of discontinuation, type of progestin and amount of estrogen.

Methods: The study population consisted of women, 18 years, enrolled in the PRegnancy and Infant DEvelopment (PRIDE) Study, an ongoing cohort study in the Netherlands recruiting since 2011. All women with an estimated date of delivery until December 31, 2019, were selected for this analysis (n=9,054). Exposed individuals used OCs within the year before conception and/or during pregnancy. Information about periconceptional OC use and pregnancy outcomes was collected using web-based questionnaires and, in case of missing data, further completed with data from obstetric records. The risk of SAB in relation to the use of OCs was estimated using Cox proportional hazards regression models, while adjusting for confounders identified in a directed acyclic graph. We stratified the analysis on timing of discontinuation, type of progestin, and amount of estrogen.

Results: In total, 7,561 women were included. Of them, 2,935 (38.8%) had used OCs in the year before and/or during pregnancy. Overall, periconceptional OC use was not associated with the risk of SAB (adjusted hazard ratio 0.89; 95% confidence interval 0.64-1.25). After stratification by timing of discontinuation, type of progestin and amount of estrogen, we did not find associations between OC use and the risk of SAB.

Conclusions: No evidence for an association between periconceptional OC use and SAB was found. These findings are reassuring for women who become pregnant shortly after discontinuing OCs.