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Pubertal development after unintended intrauterine exposure to oral contraceptives: a nationwide cohort study
Andreas Ernst1, Lea L B Lauridsen2, Nis Brix1
1Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California.
Insights
Maternal oral contraceptive use during pregnancy may slightly impact child puberty timing. Exposure before conception showed no association with pubertal development in boys or girls.
Area of Science:
- Reproductive health
- Pediatric endocrinology
- Human development
Background:
- Oral contraceptives (OCs) are widely used by women of reproductive age.
- Understanding potential effects of prenatal exposures on child development is crucial.
- Pubertal timing is a key indicator of healthy development.
Purpose of the Study:
- To investigate the association between maternal oral contraceptive (OC) use before and during early pregnancy and the timing of puberty in offspring.
- To differentiate effects of exposure before conception versus in early pregnancy.
- To explore potential mediation by prepubertal body mass index.
Main Methods:
- Population-based cohort study of 15,800 children born in Denmark (2000-2003).
- Maternal OC use categorized as no exposure, exposure before conception, or exposure in early pregnancy.
- Children self-reported pubertal status via web-based questionnaires from age 11.
Main Results:
- Intrauterine OC exposure showed a tendency toward slightly earlier pubertal timing in boys (e.g., voice break, first ejaculation) and girls (e.g., menarche, Tanner breast stages).
- No significant association was found for OC exposure before conception.
- Prepubertal body mass index did not mediate the observed effects.
Conclusions:
- Intrauterine exposure to oral contraceptives may be associated with a slight advance in pubertal timing.
- Exposure prior to conception did not appear to influence pubertal development.
- Further research is warranted to confirm these findings and elucidate mechanisms.
Objective:
To study the associations between exposure to oral contraceptives before conception and early in pregnancy and pubertal timing in boys and girls.
Design:
Population-based cohort study.
Setting:
Not applicable.
Patient(S):
Overall, 15,800 children (70%) born during 2000-2003 into the Danish National Birth Cohort were categorized according to maternal use of combined oral contraceptive pills or progestin-only pills reported around gestational week 17: no exposure (reference), exposure 4 months before conception, and exposure in early pregnancy. Children self-assessed pubertal status using Web-based questionnaires from 11 years and biannually throughout puberty.
Intervention(S):
None.
Main Outcome Measure(S):
Adjusted mean age differences (months) for attaining individual pubertal milestones and overall pubertal timing. Proportion mediated by prepubertal body mass index.
Result(S):
In boys, intrauterine exposure to oral contraceptives showed a tendency toward slightly earlier mean age for voice break (months, -3.8; 95% confidence interval [CI] -6.5, -1.0) and first ejaculation (months, -2.9; 95% CI -5.9, 0.1) and a mean difference of -1.4 months (95% CI -3.3, 0.4) for overall pubertal timing. Girls with intrauterine exposure tended to have slightly earlier age at menarche (months, -1.9; 95% CI -4.0, 0.3) and Tanner breast stages and had a mean difference of -0.9 months (95% CI -2.7, 1.0) for overall pubertal timing. Exposure before conception was not associated with pubertal timing. Prepubertal body mass index did not play a mediating role.
Conclusion(S):
This study shows some evidence that intrauterine exposure to oral contraceptives might slightly affect pubertal timing.
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