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Use of combined hormonal contraceptives among women with systemic lupus erythematosus with and without medical contraindications to oestrogen

Title
Use of combined hormonal contraceptives among women with systemic lupus erythematosus with and without medical contraindications to oestrogen
Author
배상철
Keywords
systemic lupus erythematosus; anti-phospholipid syndrome; contraception; epidemiology
Issue Date
2019-07
Publisher
OXFORD UNIV PRESS
Citation
RHEUMATOLOGY, v. 58, no. 7, Page. 1259-1267
Abstract
Objectives To assess the prevalence of combined hormonal contraceptives (CHCs) in reproductive-age women with SLE with and without possible contraindications and to determine factors associated with their use in the presence of possible contraindications. Methods This observational cohort study included premenopausal women ages 18-45 years enrolled in the SLICC Registry 15 months after SLE onset, with annual assessments spanning 2000-2017. World Health Organization Category 3 or 4 contraindications to CHCs (e.g. hypertension, aPL) were assessed at each study visit. High disease activity (SLEDAI score ˃12 or use of ˃0.5 mg/kg/day of prednisone) was considered a relative contraindication. Results A total of 927 SLE women contributed 6315 visits, of which 3811 (60%) occurred in the presence of one or more possible contraindication to CHCs. Women used CHCs during 512 (8%) visits, of which 281 (55%) took place in the setting of one or more possible contraindication. The most frequently observed contraindications were aPL (52%), hypertension (34%) and migraine with aura (22%). Women with one or more contraindication were slightly less likely to be taking CHCs [7% of visits (95% CI 7, 8)] than women with no contraindications [9% (95% CI 8, 10)]. Conclusion CHC use was low compared with general population estimates (˃35%) and more than half of CHC users had at least one possible contraindication. Many yet unmeasured factors, including patient preferences, may have contributed to these observations. Further work should also aim to clarify outcomes associated with this exposure.
URI
https://academic.oup.com/rheumatology/article/58/7/1259/5312899https://repository.hanyang.ac.kr/handle/20.500.11754/152304
ISSN
1462-0324; 1462-0332
DOI
10.1093/rheumatology/kez014
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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