Oral contraceptives increase surgery risk for women with Crohn disease

Long-term use of oral contraceptives increases the risk of surgery in women with Crohn disease, according to a study published in Gastroenterology.

For every 83 women with Crohn disease who have taken oral contraceptives for at least 1 year, 1 extra surgery is needed, researchers found.

The study included 4,036 female patients with Crohn disease (aged 16 to 51 years) from the Swedish National Patient Register from January 2002 through December 2013. Primary outcomes were first Crohn disease-related surgery and first steroid prescription.

During a median follow-up of 58 months, there were 482 cases of surgery. Compared with women who did not use oral contraceptives, women who had used oral contraceptives in the past had a hazard ratio (HR) of 1.14, and those who were currently using them had an HR of 1.30. The risk of surgery increased with longer duration of use and higher prescribed daily dose.

When the researchers analyzed the risk for surgery with different types of oral contraceptives, they found that the risk for surgery was only increased by combination oral contraceptives. Progestin-only contraceptives did not increase the risk for surgery.

Oral contraceptive use did not significantly affect the rate of steroid prescriptions among past or current users compared with nonusers.

Reference

1. Khalili H, Granath F, Smedby KE, et al. Association between long-term oral contraceptive use and risk of Crohn’s disease complications in a nationwide study. Gastroenterology. 2016;150(7):1561-1567.