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Are oral contraceptive use and pregnancy complications risk factors for atopic disorders among offspring?

Kevin Brooks1, Maureen Samms-Vaughan, Wilfried Karmaus

  • 1Department of Epidemiology, School of Human Medicine, Michigan State University, East Lansing, MI 48823, USA.

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|December 22, 2004
PubMed

Insights

Maternal oral contraceptive (OC) use before pregnancy was linked to increased childhood asthma and coughing. Complications during pregnancy (CDP) were associated with hay fever, suggesting in utero programming of atopic conditions.

Area of Science:

  • Perinatal epidemiology
  • Developmental origins of health and disease
  • Allergy and immunology

Background:

  • In utero programming is a proposed mechanism for atopic disease development.
  • The influence of maternal oral contraceptive (OC) use and complications during pregnancy (CDP) on offspring atopy requires further investigation.

Purpose of the Study:

  • To examine the association between pre-pregnancy oral contraceptive (OC) use and pregnancy complications (CDP) with childhood asthma and other atopic manifestations.
  • To explore the potential for in utero programming of atopic diseases.

Main Methods:

  • Prospective cohort study utilizing data from the Jamaican Perinatal Morbidity, Mortality Survey.
  • Maternal interviews and medical records provided data on OC use and CDP.
  • Follow-up interviews with mothers and trained nurses collected data on childhood asthma, wheezing, coughing, eczema, and hay fever at ages 11-12 years.
  • Logistic regression analysis controlled for confounders to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI).

Main Results:

  • Maternal OC use was significantly associated with an increased risk of childhood asthma or wheezing (aOR: 1.81, 95% CI: 1.25-2.61) and coughing (aOR: 2.72, 95% CI: 1.41-5.24).
  • Complications during pregnancy (CDP) were a significant risk factor only for hay fever.
  • A higher number of older siblings demonstrated a protective effect against hay fever.

Conclusions:

  • The findings suggest that maternal oral contraceptive use prior to conception may be a risk factor for the development of asthma in childhood.
  • In utero environmental exposures, potentially including maternal OC use, may play a role in programming atopic manifestations.
  • Further research is warranted to elucidate the mechanisms underlying the observed associations.

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