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Oral contraceptives, reproductive factors and risk of inflammatory bowel disease.

ABSTRACT: Oral contraceptive use has been associated with risk of Crohn's disease (CD) and ulcerative colitis (UC).To determine whether this association is confounded or modified by other important lifestyle and reproductive factors.A prospective cohort study was carried out of 117,375 US women enrolled since 1976 in the Nurses Health Study I (NHS I) and 115,077 women enrolled since 1989 in the Nurses' Health Study II (NHS II) with no prior history of UC or CD. These women had provided information every 2 years, on age at menarche, oral contraceptive use, parity, menopause status and other risk factors. Diagnoses of CD and UC were confirmed by review of medical records. Cox proportional hazards models were used to calculate HRs and 95% CIs.Among 232,452 women with over 5,030,196 person-years of follow-up, 315 cases of CD and 392 cases of UC were recorded through 2007 in NHS II and 2008 in NHS I. Compared with never users of oral contraceptives, the multivariate-adjusted HRs for CD were 2.82 (95% CI 1.65 to 4.82) among current users and 1.39 (95% CI 1.05 to 1.85) among past users. The association between oral contraceptives and UC differed according to smoking history (pheterogeneity=0.04). Age at menarche, age at first birth and parity were not associated with risk of UC or CD.In two large prospective cohorts of US women, oral contraceptive use was associated with risk of CD. The association between oral contraceptive use and UC was limited to women with a history of smoking.

SUBMITTER: Khalili H

PROVIDER: S-EPMC3465475 | biostudies-literature | 2013 Aug

REPOSITORIES: biostudies-literature

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Oral contraceptives, reproductive factors and risk of inflammatory bowel disease.

Khalili Hamed H Higuchi Leslie M LM Ananthakrishnan Ashwin N AN Richter James M JM Feskanich Diane D Fuchs Charles S CS Chan Andrew T AT

Gut 20120522 8

<h4>Background</h4>Oral contraceptive use has been associated with risk of Crohn's disease (CD) and ulcerative colitis (UC).<h4>Objective</h4>To determine whether this association is confounded or modified by other important lifestyle and reproductive factors.<h4>Design</h4>A prospective cohort study was carried out of 117,375 US women enrolled since 1976 in the Nurses Health Study I (NHS I) and 115,077 women enrolled since 1989 in the Nurses' Health Study II (NHS II) with no prior history of UC ...[more]

PMID: 22619368

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Project description:Background: The COVID-19 pandemic led to the urgent implementation of telehealth visits in inflammatory bowel disease (IBD) care; however, data assessing feasibility remain limited. Objectives: We looked to determine the completion rate of telehealth appointments for adults with IBD, as well as to evaluate demographic, clinical, and social predictors of incomplete appointments. Design: We conducted a retrospective analysis of all patients with IBD who had at least one scheduled telehealth visit at the NYU IBD Center between 1 March 2020 and 31 August 2021, with only the first scheduled telehealth appointment considered. Methods: Medical records were parsed for relevant covariables, and multivariable logistic regression was used to estimate the adjusted association between demographic factors and an incomplete telehealth appointment. Results: From 1 March 2020 to 31 August 2021, there were 2508 patients with IBD who had at least one telehealth appointment, with 1088 (43%) having Crohn’s disease (CD), 1037 (41%) having ulcerative colitis (UC), and 383 (15%) having indeterminate colitis. Of the initial telehealth visits, 519 (21%) were not completed, including 435 (20%) among patients <60 years as compared to 84 (23%) among patients ⩾60 years (p = 0.22). After adjustment, patients with CD had higher odds of an incomplete appointment as compared to patients with UC [adjusted odds ratio (adjOR): 1.37, 95% confidence interval (CI): 1.10–1.69], as did females (adjOR: 1.26, 95% CI: 1.04–1.54), and patients who had a non-first-degree relative listed as an emergency contact (adjOR: 1.69, 95% CI: 1.16–2.44). While age ⩾60 years was not associated with appointment completion status, we did find that age >80 years was an independent predictor of missed telehealth appointments (adjOR: 2.92, 95% CI: 1.12–7.63) when compared to individuals aged 60–70 years. Conclusion: Patients with CD, females, and those with less social support were at higher risk for missed telehealth appointments, as were adults >80 years. Engaging older adults via telehealth, particularly those aged 60–80 years, may therefore provide an additional venue to complement in-person care.

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Oral contraceptives, reproductive factors and risk of inflammatory bowel disease.

Publications

Oral contraceptives, reproductive factors and risk of inflammatory bowel disease.

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