Meta-analysis of the role of oral contraceptive agents in inflammatory bowel disease.

Abstract

Numerous epidemiological studies have been performed to determine factors that might contribute to the development of inflammatory bowel disease. Although the role oforal contraceptive agents in Crohn's disease (CD) and ulcerative colitis (UC) have been assessed, most studies were of small sample size and characterised by low statistical precision. A meta-analysis was performed to increase the statistical power and to investigate the association between the use of oral contraceptives and the development of CD and UC. The study was based on a search of a Medline database from 1975 to October 1993 and a review of reference lists from published articles, reviews, symposia proceedings, and abstracts from major gastrointestinal meetings. All studies specifically designed to evaluate this association were selected. The combined results of nine studies -two cohort studies (30 379 unexposed and 30 673 exposed patients) and seven case-control studies (482 CD, 237 UC, and 3198 controls) -which satisfied our selection criteria were evaluated. The pooled relative risk (adjusted for smoking) associated with oral contraceptive use was 1.44 (1.12, 1.86) for CD and 1.29 (0.94, 1.77) for UC. These results suggest modest associations between the use of oral contraceptives and the development of CD and UC. As these associations are weak, non-causal explanations for the findings cannot be eliminated. (Gut 1995; 37: 668-673)

Breastfeeding and genetic factors in the etiology of inflammatory bowel disease in children

“…Paradoxically, cigarette smoking is a risk factor for CD, but a protective factor for UC [12] . OC use may also play a role in the etiology of CD although, obviously, only in women [13,14] . Numerous dietary components may play a role in the etiology of IBD although these associations are less certain [16,17] .…”

“…Numerous dietary components may play a role in the etiology of IBD although these associations are less certain [16,17] . Many investigators have identified associations between preceding infections and the development of IBD [13,[18][19][20]23,24] and some have identified associations between antibiotic use and development of IBD [23,24] . Many perinatal factors have been studied, but no consistent findings have been reported [21][22][23][25][26][27] .…”

“…Epidemiologic investigations of the relationship between OC agents and IBD yielded mixed results. A meta-analysis of these studies showed evidence of a modestly increased risk for CD and UC in OC users (Table 4) [13] . A more recent study confirmed the modestly increased risk of CD and UC in former and current users of OC agents, but the difference was statistically significant only for current users of OC agents and CD [ψ = 3.4 (1.0-11.9), n = 106 age-matched pairs] [14] .…”

Pathogenesis of Ulcerative Colitis and Crohn’s Disease: Similarities, Differences and a Lot of Things We Do Not Know Yet

“…Several publications have reported an increased risk of CD [97,139] or both CD and UC [140] among women using oral contraceptives. Similarly, a recent prospective cohort study has found that oral contraceptive use increased the risk of CD, but elevated risk of UC was only observed in women with a history of smoking [141].…”

Inflammatory bowel disease and oral health

“…29 Oral contraceptives statistically significantly increased the risk for developing CD and appeared to increase the risk of UC. 30 The other important environmental factor playing on the development of IBD is diet control. The greatest association appears to be between increased sugar intake and developing IBD.…”