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Does the pill make a difference? Previous maternal use of contraceptive pills and allergic diseases among offspring

L Keski-Nisula1, J Pekkanen, B Xu

  • 1Environmental Epidemiology Unit, National Public Health Institute, Kuopio, Finland.

Allergy
|November 1, 2006
PubMed

Insights

Maternal use of certain oral contraceptive pills (OCPs) before pregnancy is linked to an increased risk of allergic rhinitis in children. This risk is particularly noted in boys and those with a family history of allergies.

Area of Science:

  • Reproductive Endocrinology
  • Pediatric Allergy
  • Immunology

Background:

  • Maternal oral contraceptive pill (OCP) use is a potential factor influencing offspring allergic disease prevalence.
  • Specific OCP formulations may differentially impact this association.

Purpose of the Study:

  • To investigate if different types of oral contraceptive pills (OCPs) used by mothers before pregnancy are associated with varying risks of allergic diseases in offspring.
  • To identify specific OCP components linked to increased allergy risk.

Main Methods:

  • A cohort study involving 1182 children aged 5-6 years, including 618 with asthma and 564 controls.
  • Primary outcomes assessed were asthma, allergic rhinitis, and atopic eczema.
  • Maternal OCP use history prior to pregnancy was recorded.

Main Results:

  • Maternal use of desogestrel, gestodene, or cyproterone acetate with ethinyloestradiol (EO) before pregnancy was associated with a higher risk of allergic rhinitis in offspring (OR 1.67).
  • This increased risk was more pronounced in children with parental allergy (OR 1.78) and significantly higher in boys (OR 2.12).
  • No association was found between maternal OCP use and offspring asthma or atopic eczema. Progesterone levels were higher in mothers using more androgenic progestins.

Conclusions:

  • Maternal pre-pregnancy use of specific OCPs (desogestrel, gestodene, cyproterone acetate with EO) elevates the risk of allergic rhinitis in offspring.
  • The heightened risk is primarily observed in boys and children with a parental history of allergy.
  • The association is not mediated by maternal sex steroid levels but may relate to progestin androgenicity and progesterone levels.
Abstract

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