Pharmacoepidemiological Analysis of Oral Contraceptive Use in Adolescents in a German Longitudinal Cohort Study

Markus Herzig; Astrid Bertsche; Cornelia Hilbert; Wieland Kiess; Thilo Bertsche; Martina Patrizia Neininger

doi:10.3390/children10020393

Pharmacoepidemiological Analysis of Oral Contraceptive Use in Adolescents in a German Longitudinal Cohort Study

Children (Basel). 2023 Feb 16;10(2):393. doi: 10.3390/children10020393.

Authors

Markus Herzig^{1

2}, Astrid Bertsche^{3

4}, Cornelia Hilbert^{3

5}, Wieland Kiess^{3

5}, Thilo Bertsche^{1

2}, Martina Patrizia Neininger^{1

2}

Affiliations

¹ Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, Brüderstraße 32, 04103 Leipzig, Germany.
² Drug Safety Center, Leipzig University and University Hospital, Brüderstraße 32, 04103 Leipzig, Germany.
³ Center for Pediatric Research, University Hospital for Children and Adolescents, Liebigstraße 20a, 04103 Leipzig, Germany.
⁴ Division of Neuropediatrics, University Hospital for Children and Adolescents, Fleischmannstr. 8, 17475 Greifswald, Germany.
⁵ LIFE Leipzig Research Centre for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Straße 27, 04103 Leipzig, Germany.

Abstract

To assess the use of oral contraceptives (OC) in adolescents, using data from a longitudinal, population-based pediatric cohort study (LIFE Child). We also investigated associations between OC use and socioeconomic status (SES), and associations between OC use and potential adverse drug reactions such as effects on blood pressure. We included 609 female participants of the LIFE Child cohort, aged ≥13 to <21 years, who visited the study center between 2012 and 2019. Data collection compromised drug use in the past 14 days, SES, and anthropometric data such as blood pressure. An analysis of covariance was used to detect potential associations between participants' blood pressure and OC. Multivariate binary logistic regression was used to obtain odds ratios (aOR) adjusted for age and 95% confidence intervals (95% CI). The prevalence of OC use was 25.8%. OC intake was less common in participants with a high SES (aOR 0.30, 95% CI 0.15, 0.62). The mean age at OC initiation did not change between 2012 and 2019. We observed an increased use of second-generation OC (2013: 17.9%, 2019: 48.5%; p = 0.013) and a decreased use of fourth-generation OC (2013: 71.8%, 2019: 45.5%; p = 0.027). We found a higher systolic (mean: 111.74 mmHg, p < 0.001) and diastolic (69.15 mmHg, p = 0.004) blood pressure in OC users compared to non-users (systolic: 108.60 mmHg; diastolic: 67.24 mmHg). Every fourth adolescent took an OC. The share of second-generation OC increased during the study period. OC intake was associated with low SES. OC users had a slightly higher blood pressure than non-users.

Keywords: adolescent; blood pressure; cohort study; contraceptive agents; pediatrics; pharmacoepidemiology.

Grants and funding

LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig. LIFE is funded by means of the European Union, by means of the European Social Fund (ESF, https://ec.europa.eu/esf/home.jsp?langId=en/, accessed on 15 February 2022), by the European Regional Development Fund (ERDF, https://ec.europa.eu/regional_policy/funding/erdf_en/, accessed on 15 February 2022), and by means of the Free State of Saxony. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This research received no special funding. The publication of this manuscript was funded by the Open Access Publishing Fund of Leipzig University supported by the German Research Foundation within the program Open Access Publication Funding.