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Grand Rounds

Does Hormonal Contraception Use Increase Risk of Childhood Central Nervous System Tumors?

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BACKGROUND AND PURPOSE: 

  • Limited knowledge regarding risk factors for CNS tumors among children
    • A few studies have assessed the link between maternal hormonal contraception and offspring CNS tumors, but data are conflicting  
  • Hargreave et al. (JAMA, 2022) examined the association between maternal hormonal contraception use and CNS tumors in children (<20 years) 

METHODS: 

  • Nationwide cohort study 
  • Population 
    • Children born in Denmark between between January, 1996, and December, 2014 
  • Exposures 
    • Maternal hormonal contraception  
  • Study design 
    • Maternal hormonal contraception  
      • Any use 
      • Regimen: Combined/progestin only 
      • Route of administration: Oral/nonoral  
    • Timing 
      • Recent use (≤3 months before start and during pregnancy)  
      • Previous use (>3 months before start of pregnancy)   
    • Primary Outcome Assessment   
      • Hazard ratio  
      • Incidence rate difference 
  • Primary Outcome 
    • CNS tumors diagnosed at younger than 20 years 

RESULTS: 

  • 1,185,063 children born during study period 
    • 15,335,990 person-years of follow-up | Mean follow-up 12.9 years 
  • Total CNS tumors diagnosed in children: 725 
    • Mean age at diagnosis: 7 years 
    • 47.2% of those diagnosed were female 
  • Adjusted incidence rates of CNS tumors 
    • Children born to mothers with recent hormonal contraception use 
      • 5.0 per 100,000 person-years 
    • Children born to mothers with previous use 
      • 4.5 per 100,000 person-years 
    • Children born to mothers with no use 
      • 5.3 per 100,000 person-years 
  • Hazard ratios (HR) and incidence rate differences vs no use 
    • Children born to mothers with recent hormonal contraception use 
      • HR 0.95 (95% CI, 0.74 to 1.23) 
      • Incidence rate difference −0.3 (95% CI, −1.6 to 1.0) 
    • Children born to mothers with previous use 
      • HR 0.86 (95% CI, 0.72 to 1.02) 
      • Incidence rate difference  
  • No statistically significant associations were found for recent or previous use of any hormonal contraception examined vs no use  
    • Oral combined | Nonoral combined | Oral progestin only | Nonoral products  

CONCLUSION: 

There is no significant link between maternal hormonal contraception use and risk of childhood CNS tumors 

Learn More – Primary Sources: 

Association Between Maternal Hormonal Contraception Use and Central Nervous System Tumors in Children 

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Do New Birth Control Pills Increase Risk for Venous Thromboembolism?
Does Hormonal Contraceptive Use Lower the Incidence of Severe Asthma Events?
Is Progestin-Based Contraception Linked to Depression?

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