{"title":"激素避孕药的使用与贫血:北欧国家药物流行病学研究。","authors":"Sofie Ekroos,Elena Toffol,Oskari Heikinheimo,Jari Haukka,Mikko Arvas","doi":"10.1007/s10654-025-01272-3","DOIUrl":null,"url":null,"abstract":"The WHO aims to reduce iron deficiency anaemia globally. Use of modern hormonal contraception (HC) could offer protection against anaemia in premenopausal women, but population-level effectiveness is unclear. We aim to quantify the effect of HC on anaemia. This nested case-control study includes over half the fertile-aged female population of Finland in 2017. Data on HC use from the national Prescription Center were combined with data on anaemia diagnosis from national care registries. Cases (anaemia diagnosis during follow-up, 2019-2020) were matched with up to five controls by age and municipality. After calculating the minimally sufficient adjustment set, adjusted odds ratios were derived in a conditional multivariable regression model accounting for matching. 3 100 cases of anaemia were matched with 13 143 controls. The minimally sufficient adjustment set included age, education level, obesity, abnormal uterine bleeding, and cancer. Compared to non-users of HC, risk of anaemia was lower in users of combined oral contraceptives containing ethinylestradiol (0·74 [0·66-0·83]) or oestradiol (0·49 [0·35-0·68]), progestin-only oral contraceptives (0·42 [0·35-0·51]), LNG-IUDs (0·64 [0·43-0·94]), and contraceptive vaginal rings (0·68 [0·49-0·94]). Individual product effects ranged from 0·77 [0·66-0·90] for drospirenone and ethinylestradiol to 0·40 [0·32-0·48] for desogestrel-only. Benefits of HC use extend to anaemia protection on population level. Anaemia protection should be included in guidelines on HC to support clinical decision making.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"72 1","pages":""},"PeriodicalIF":5.9000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hormonal contraceptive use and anaemia: a nation-wide pharmacoepidemiological study from Northern Europe.\",\"authors\":\"Sofie Ekroos,Elena Toffol,Oskari Heikinheimo,Jari Haukka,Mikko Arvas\",\"doi\":\"10.1007/s10654-025-01272-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The WHO aims to reduce iron deficiency anaemia globally. Use of modern hormonal contraception (HC) could offer protection against anaemia in premenopausal women, but population-level effectiveness is unclear. We aim to quantify the effect of HC on anaemia. This nested case-control study includes over half the fertile-aged female population of Finland in 2017. Data on HC use from the national Prescription Center were combined with data on anaemia diagnosis from national care registries. Cases (anaemia diagnosis during follow-up, 2019-2020) were matched with up to five controls by age and municipality. After calculating the minimally sufficient adjustment set, adjusted odds ratios were derived in a conditional multivariable regression model accounting for matching. 3 100 cases of anaemia were matched with 13 143 controls. The minimally sufficient adjustment set included age, education level, obesity, abnormal uterine bleeding, and cancer. Compared to non-users of HC, risk of anaemia was lower in users of combined oral contraceptives containing ethinylestradiol (0·74 [0·66-0·83]) or oestradiol (0·49 [0·35-0·68]), progestin-only oral contraceptives (0·42 [0·35-0·51]), LNG-IUDs (0·64 [0·43-0·94]), and contraceptive vaginal rings (0·68 [0·49-0·94]). Individual product effects ranged from 0·77 [0·66-0·90] for drospirenone and ethinylestradiol to 0·40 [0·32-0·48] for desogestrel-only. Benefits of HC use extend to anaemia protection on population level. Anaemia protection should be included in guidelines on HC to support clinical decision making.\",\"PeriodicalId\":11907,\"journal\":{\"name\":\"European Journal of Epidemiology\",\"volume\":\"72 1\",\"pages\":\"\"},\"PeriodicalIF\":5.9000,\"publicationDate\":\"2025-07-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Epidemiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10654-025-01272-3\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10654-025-01272-3","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Hormonal contraceptive use and anaemia: a nation-wide pharmacoepidemiological study from Northern Europe.
The WHO aims to reduce iron deficiency anaemia globally. Use of modern hormonal contraception (HC) could offer protection against anaemia in premenopausal women, but population-level effectiveness is unclear. We aim to quantify the effect of HC on anaemia. This nested case-control study includes over half the fertile-aged female population of Finland in 2017. Data on HC use from the national Prescription Center were combined with data on anaemia diagnosis from national care registries. Cases (anaemia diagnosis during follow-up, 2019-2020) were matched with up to five controls by age and municipality. After calculating the minimally sufficient adjustment set, adjusted odds ratios were derived in a conditional multivariable regression model accounting for matching. 3 100 cases of anaemia were matched with 13 143 controls. The minimally sufficient adjustment set included age, education level, obesity, abnormal uterine bleeding, and cancer. Compared to non-users of HC, risk of anaemia was lower in users of combined oral contraceptives containing ethinylestradiol (0·74 [0·66-0·83]) or oestradiol (0·49 [0·35-0·68]), progestin-only oral contraceptives (0·42 [0·35-0·51]), LNG-IUDs (0·64 [0·43-0·94]), and contraceptive vaginal rings (0·68 [0·49-0·94]). Individual product effects ranged from 0·77 [0·66-0·90] for drospirenone and ethinylestradiol to 0·40 [0·32-0·48] for desogestrel-only. Benefits of HC use extend to anaemia protection on population level. Anaemia protection should be included in guidelines on HC to support clinical decision making.
期刊介绍:
The European Journal of Epidemiology, established in 1985, is a peer-reviewed publication that provides a platform for discussions on epidemiology in its broadest sense. It covers various aspects of epidemiologic research and statistical methods. The journal facilitates communication between researchers, educators, and practitioners in epidemiology, including those in clinical and community medicine. Contributions from diverse fields such as public health, preventive medicine, clinical medicine, health economics, and computational biology and data science, in relation to health and disease, are encouraged. While accepting submissions from all over the world, the journal particularly emphasizes European topics relevant to epidemiology. The published articles consist of empirical research findings, developments in methodology, and opinion pieces.