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dc.contributor.authorGlisic, Marija
dc.contributor.authorShahzad, Sara
dc.contributor.authorTsoli, Stergiani
dc.contributor.authorChadni, Mahmuda
dc.contributor.authorAsllanaj, Eralda
dc.contributor.authorRojas, Lyda Z
dc.contributor.authorBrown, Elizabeth
dc.contributor.authorChowdhury, Rajiv
dc.contributor.authorMuka, Taulant
dc.contributor.authorFranco, Oscar H
dc.date.accessioned2018-12-08T00:32:05Z
dc.date.available2018-12-08T00:32:05Z
dc.date.issued2018-07
dc.identifier.issn2047-4873
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/286572
dc.description.abstractAims The association between progestin-only contraceptive (POC) use and the risk of various cardiometabolic outcomes has rarely been studied. We performed a systematic review and meta-analysis to determine the impact of POC use on cardiometabolic outcomes including venous thromboembolism, myocardial infarction, stroke, hypertension and diabetes. Methods and results Nineteen observational studies (seven cohort and 12 case-control) were included in this systematic review. Of those, nine studies reported the risk of venous thromboembolism, six reported the risk of myocardial infarction, six reported the risk of stroke, three reported the risk of hypertension and two studies reported the risk of developing diabetes with POC use. The pooled adjusted relative risks (RRs) for venous thromboembolism, myocardial infarction and stroke for oral POC users versus non-users based on the random effects model were 1.06 (95% confidence interval (CI) 0.70-1.62), 0.98 (95% CI 0.66-1.47) and 1.02 (95% CI 0.72-1.44), respectively. Stratified analysis by route of administration showed that injectable POC with a RR of 2.62 (95% CI 1.74-3.94), but not oral POCs (RR 1.06, 95% CI 0.7-1.62), was associated with an increased risk of venous thromboembolism. A decreased risk of venous thromboembolism in a subgroup of women using an intrauterine levonorgestrel device was observed with a RR of 0.53 (95% CI 0.32-0.89). No effect of POC use on blood pressure was found, but there was an indication for an increased risk of diabetes with injectable POCs, albeit non-significant. Conclusions This systematic review and meta-analysis suggests that oral POC use is not associated with an increased risk of developing various cardiometabolic outcomes, whereas injectable POC use might increase the risk of venous thromboembolism.
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherOxford University Press (OUP)
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.subjectHumans
dc.subjectCardiovascular Diseases
dc.subjectDiabetes Mellitus
dc.subjectContraceptives, Oral, Hormonal
dc.subjectDrug Implants
dc.subjectProgestins
dc.subjectAdministration, Oral
dc.subjectInjections
dc.subjectRisk Assessment
dc.subjectRisk Factors
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectVenous Thromboembolism
dc.subjectYoung Adult
dc.titleAssociation between progestin-only contraceptive use and cardiometabolic outcomes: A systematic review and meta-analysis.
dc.typeArticle
prism.endingPage1052
prism.issueIdentifier10
prism.publicationDate2018
prism.publicationNameEur J Prev Cardiol
prism.startingPage1042
prism.volume25
dc.identifier.doi10.17863/CAM.33882
rioxxterms.versionofrecord10.1177/2047487318774847
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-07
dc.contributor.orcidChowdhury, Rajiv [0000-0003-4881-5690]
dc.identifier.eissn2047-4881
rioxxterms.typeJournal Article/Review
pubs.funder-project-idMedical Research Council (MR/L003120/1)
pubs.funder-project-idBritish Heart Foundation (None)
cam.issuedOnline2018-05-10


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Attribution-NonCommercial 4.0 International
Except where otherwise noted, this item's licence is described as Attribution-NonCommercial 4.0 International