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首页> 外文期刊>Contraception >Use of oral contraceptives containing gestodene and risk of venous thromboembolism: outlook 10 years after the third-generation 'pill scare'.
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Use of oral contraceptives containing gestodene and risk of venous thromboembolism: outlook 10 years after the third-generation 'pill scare'.

机译：使用含有孕二烯酮的口服避孕药和静脉血栓栓塞的风险：第三代“药丸恐慌”后的十年。

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BACKGROUND: This study investigated whether gestodene-containing oral contraceptives (OCs) carry a higher risk of venous thromboembolism (VTE) than OCs containing progestins other than desogestrel and gestodene. The study was conducted based on the hypothesis that the biases and confounding factors that were present initially after the introduction of new so-called "third-generation" OCs (i.e., those containing desogestrel and gestodene) in the 1990s, which likely contributed to the alleged increased risk of VTE, may have vanished after 10 years. STUDY DESIGN: This was a matched case-control study using data identified for women (aged 15-49 years) with suspected or diagnosed VTE (deep vein thrombosis or pulmonary embolism) that occurred between January 2002 and February 2006 in Austria. All VTE cases were validated by an attending/relevant physician(s), a detailed review of medical records and patient-completed questionnaires. Data were analyzed using an unconditional logistic regression model with adjustment for relevant confounders. RESULTS: Overall, 451 VTE cases and 1,920 controls without VTE were identified. The adjusted odds ratios for confirmed VTE with OC use versus nonuse were: 3.39 (95% CI 2.36-4.87) for OCs containing gestodene and 3.14 (2.1-4.47) for OCs containing progestins other than desogestrel and gestodene. Adjusted odds ratios for a head-to-head comparison of OCs containing gestodene versus OCs containing progestins other than desogestrel and gestodene were: 0.99 (0.68-1.45) for all cases; 1.01 (0.69-1.47) for confirmed cases and 1.11 (0.73-1.69) for confirmed and idiopathic VTE cases, respectively. CONCLUSION: The risk of VTE is not elevated in users of gestodene-containing OCs relative to users of OCs containing progestins other than desogestrel and gestodene. Our study supports the view that (i) the majority of previous results may be explained by differences in the user populations of so-called "third-generation" OCs (containing desogestrel and gestodene) and second-generation gestodene) that were present shortly after market introduction of gestodene-containing OCs and that (ii) these differences seem to have disappeared over time.
机译：背景：这项研究调查了含有孕二烯的口服避孕药（OCs）是否比除地孕孕酮和孕二烯之外的含有孕激素的OC具有更高的静脉血栓栓塞（VTE）风险。该研究基于以下假设进行：1990年代引入新的所谓的“第三代” OC（即那些含有去氧孕烯和孕二烯酮的OC）后最初存在的偏见和混淆因素。所谓的VTE风险增加，可能在10年后消失。研究设计：这是一项匹配的病例对照研究，使用的数据来自2002年1月至2006年2月在奥地利发生的疑似或诊断为VTE（深静脉血栓形成或肺栓塞）的女性（15-49岁）。所有的VTE病例均由主治医生/相关医生，病历的详细审阅和患者填写的问卷进行了验证。使用无条件逻辑回归模型对数据进行分析，并调整相关混杂因素。结果：总共鉴定出451例VTE病例和1,920例无VTE的对照。确认使用OC的VTE与不使用VTE的调整后的优势比为：对于含有孕二烯烯的OC，3.39（95％CI 2.36-4.87），对于对孕烯醇不是去氧孕烯和孕二烯的OC，则为3.14（2.1-4.47）。头对头比较含有孕二烯酮的OC与不含去氧孕烯和孕酮的孕激素的OC的经调整比值比为：所有情况下均为0.99（0.68-1.45）;确诊病例和特发性VTE病例分别为1.01（0.69-1.47）和1.11（0.73-1.69）。结论：相对于除孕烯醇和孕二烯以外的孕激素的OC使用者，含孕二烯的OC使用者的VTE风险并未升高。我们的研究支持以下观点：（i）先前的大多数结果都可以通过不久之后出现的所谓“第三代” OC（包含去氧孕烯和孕二烯）和第二代孕二烯的用户群体的差异来解释。含孕二烯的OC的市场介绍以及（ii）这些差异似乎随着时间的流逝而消失了。

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