Maternal hormonal contraceptive use and offspring overweight or obesity

Int J Obes (Lond). 2014 Oct;38(10):1275-81. doi: 10.1038/ijo.2014.114. Epub 2014 Jul 2.


Background/objectives: Experiments in animal models have shown a positive association between in utero exposure to pharmacologic sex hormones and offspring obesity. The developmental effects of such hormones on human obesity are unknown.

Subjects/methods: Using data from a large, prospective pregnancy cohort study (n=19 652), with linkage to a national prescription registry, we evaluated the association between use of hormonal contraceptives before and after conception (defined from dispensed prescription data and characterized by last date of use relative to conception, 12 to >4 months before (n=3392), 4 to >1 months before (n=2541), 1 to >0 months before (n=2997) and 0-12 weeks after (n=567)) in relation to offspring overweight or obesity at age 3 years.

Results: We observed a weak, inverse association between early pregnancy use of a combination oral contraceptive and offspring overweight or obesity at age 3 (adjusted odds ratio (OR): 0.75, 95% confidence interval (CI): 0.53, 1.08) and a positive, but imprecise, association with use of a progestin-only oral contraceptive in early pregnancy (adjusted OR: 1.26, 95% CI: 0.79, 2.02). In general, no association was observed between the use of a hormonal contraceptive before conception and offspring overweight or obesity. A sensitivity analysis comparing combination oral contraceptive users in early pregnancy to other unplanned pregnancies without hormonal contraceptive use further strengthened the inverse association (adjusted OR: 0.70, 95% CI: 0.48, 1.02). Other sensitivity analyses were conducted to evaluate the robustness of the associations observed given varying assumptions.

Conclusions: Pharmacologic sex hormones in early pregnancy may be inversely or positively associated with offspring overweight or obesity at age 3, depending on the specific formulation used. The present study provides support for the potential for environmental sources of hormonally active agents to exert developmental effects.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Contraceptive Agents, Female / adverse effects*
  • Contraceptive Agents, Female / pharmacology
  • Contraceptives, Oral, Combined / adverse effects
  • Contraceptives, Oral, Hormonal / adverse effects
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Norway / epidemiology
  • Odds Ratio
  • Pediatric Obesity / chemically induced*
  • Pediatric Obesity / epidemiology
  • Pregnancy
  • Pregnancy, Unplanned
  • Prenatal Exposure Delayed Effects / chemically induced*
  • Prenatal Exposure Delayed Effects / epidemiology
  • Prospective Studies


  • Contraceptive Agents, Female
  • Contraceptives, Oral, Combined
  • Contraceptives, Oral, Hormonal