Section 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.
Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
Fertil Steril. 2019 Sep;112(3):552-561.e2. doi: 10.1016/j.fertnstert.2019.05.011. Epub 2019 Jul 13.
To study the associations between exposure to oral contraceptives before conception and early in pregnancy and pubertal timing in boys and girls.
Population-based cohort study.
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.
研究女性在受孕前和孕早期暴露于口服避孕药与男童和女童青春期启动时间的关联。
基于人群的队列研究。
不适用。
总体而言，15800 名（70%）2000-2003 年期间出生于丹麦全国出生队列的儿童，根据母亲在妊娠第 17 周左右报告的使用复方口服避孕药或单纯孕激素避孕药的情况进行分类：无暴露（参照）、受孕前 4 个月暴露和孕早期暴露。儿童在 11 岁时使用基于网络的问卷自我评估青春期状态，并在整个青春期期间每半年评估一次。
无。
达到个体青春期里程碑和整体青春期启动时间的调整后平均年龄差异（月）。由青春期前体重指数介导的比例。
在男孩中，宫内接触口服避孕药与嗓音变声（月，-3.8；95%置信区间[CI]：-6.5，-1.0）和首次射精（月，-2.9；95% CI：-5.9，0.1）的平均年龄略有提前趋势，整体青春期启动时间的平均差异为-1.4 个月（95% CI：-3.3，0.4）。宫内暴露的女孩月经初潮年龄（月，-1.9；95% CI：-4.0，0.3）和乳房发育阶段略有提前，整体青春期启动时间的平均差异为-0.9 个月（95% CI：-2.7，1.0）。受孕前接触避孕药与青春期启动时间无关。青春期前体重指数未发挥中介作用。
本研究表明，宫内接触口服避孕药可能会略微影响青春期启动时间。
