In Utero Exposure to Hormonal Contraception and Long-term Child Mortality: a nationwide cohort study

Abstract

Abstract Approximately 400 million women of the reproductive-age use hormonal contraceptives worldwide. Eventually pregnancy sometimes occur due to irregular use. Use in early pregnancy has been found associated with child morbidities, including cancer, the main reason for disease-related death in children. Here, we add the missing piece about in utero exposure to hormonal contraception and child mortality in offspring; including assessments of prognosis in children with cancer. In utero exposure to hormonal contraception was associated with increased child mortality (hazard ratio (HR) 1.22 (95% confidence interval [CI] 1.01–1.48), compared to children of mothers with previous use. The HRs were 1.22 (95% CI 0.99–1.13) for oral combined products and 2.92, (95% CI 1.21–7.04) for non-oral progestin only products. Poorer prognosis was also found in exposed children with leukemia (3.62 [95% CI: 1.33–9.87]). If causal, hormonal contraception in pregnancy seem detrimental for offspring health; and a marker of poorer prognosis in children with leukemia.