Abstract:
BACKGROUND:Oral contraceptives (OCs) are one of the most commonly used classes of drugs worldwide. A case of neutropenia and associated infections in a young woman using OCs that settled after discontinuation and reappeared upon re-challenge, has led us to investigate a potential association between oral contraceptives and neutropenia. OBJECTIVES:To compare rates of neutropenia among women receiving OCs to a matched control group of women not exposed to the "pill". PATIENTS AND METHODS:In this population-based cohort study we used a large computerized database of a health fund, comparing women prescribed OCs and a control group not using the pill. We selected a cohort of 51,394 OC users aged 16-40 years who purchased their first monthly pack of OCs between 2010 and 2018. Controls included all non-pregnant women aged 16-40 years for whom OC was not dispensed (n = 140,932). Neutrophil count before and during OC were compared. RESULTS:Prior to OC exposure, 1.3% of the women were neutropenic, compared to 1.6% after exposure to OC (RR 1.22; 95% CI 1.1-1.35). Mean neutrophil count changed from 3.87 × 103 to 3.82 × 103 mm3 (p < 0.001). In the control group (n = 140,932) no difference was seen in the proportion of neutropenic women between the first complete blood count (1.7%) compared to the second (1.8%) count (p = 0.305). In all severity levels, neutropenia was significantly more common in the OC group. The relative risk was higher for severe (RR 1.63) than for mild neutropenia (RR 1.13) (p = 0.034 for trend). CONCLUSIONS:There is a significant increase in the proportion of neutropenic women after initiating OCs. More research is needed in order to evaluate the effect of neutropenia in this group of women.
journal_name
Clin Drug Investigjournal_title
Clinical drug investigationauthors
Rosenthal YS,Chodick G,Rosenthal A,Shalev V,Ram HS,Koren Gdoi
10.1007/s40261-019-00818-0subject
Has Abstractpub_date
2019-10-01 00:00:00pages
927-930issue
10eissn
1173-2563issn
1179-1918pii
10.1007/s40261-019-00818-0journal_volume
39pub_type
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