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Maternal hormonal contraceptive use and offspring overweight or obesity

International Journal of Obesity volume 38, pages 1275–1281 (2014)Cite this article

Subjects

Abstract

Background/objectives:

Experiments in animal models have shown a positive association between in utero exposure to pharmacologic sex hormones and offspring obesity. The developmental effects of such hormones on human obesity are unknown.

Subjects/methods:

Using data from a large, prospective pregnancy cohort study (n=19 652), with linkage to a national prescription registry, we evaluated the association between use of hormonal contraceptives before and after conception (defined from dispensed prescription data and characterized by last date of use relative to conception, 12 to >4 months before (n=3392), 4 to >1 months before (n=2541), 1 to >0 months before (n=2997) and 0–12 weeks after (n=567)) in relation to offspring overweight or obesity at age 3 years.

Results:

We observed a weak, inverse association between early pregnancy use of a combination oral contraceptive and offspring overweight or obesity at age 3 (adjusted odds ratio (OR): 0.75, 95% confidence interval (CI): 0.53, 1.08) and a positive, but imprecise, association with use of a progestin-only oral contraceptive in early pregnancy (adjusted OR: 1.26, 95% CI: 0.79, 2.02). In general, no association was observed between the use of a hormonal contraceptive before conception and offspring overweight or obesity. A sensitivity analysis comparing combination oral contraceptive users in early pregnancy to other unplanned pregnancies without hormonal contraceptive use further strengthened the inverse association (adjusted OR: 0.70, 95% CI: 0.48, 1.02). Other sensitivity analyses were conducted to evaluate the robustness of the associations observed given varying assumptions.

Conclusions:

Pharmacologic sex hormones in early pregnancy may be inversely or positively associated with offspring overweight or obesity at age 3, depending on the specific formulation used. The present study provides support for the potential for environmental sources of hormonally active agents to exert developmental effects.

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Acknowledgements

We are grateful to all the participating families in Norway who took part in this ongoing cohort study. This work was supported in part by the Intramural Research Program of the National Institutes of Health, National Institute of Environmental Health Sciences (ES102985 to CJW), the University of North Carolina institutional training grant award for reproductive, perinatal, and pediatric epidemiology (grant T32HD052468 to ETJ), the National Cancer Institute (1K01CA172717-01 to WRR), and the Carolina Population Center (R24 HD050924 to WRR). The Norwegian Mother and Child Cohort Study is supported by the Norwegian Ministry of Health, contract N01-ES-75558 with the NIH/NIEHS, NIH/National Institute of Neurological Disorders and Stroke (grant 1 UO1 NS 047537-01) and the Norwegian Research Council/FUGE (grant 151918/S10).

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Authors and Affiliations

  1. Department of Epidemiology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA

    E T Jensen, C J Williams & M P Longnecker

  2. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    E T Jensen, J L Daniels, T Stürmer & W R Robinson

  3. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway

    D Moster

  4. Department of Clinical Science, University of Bergen, Bergen, Norway

    P B Juliusson

  5. Division of Epidemiology, National Institute of Public Health, Oslo, Norway

    K Vejrup & P Magnus

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  1. E T Jensen
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Correspondence to E T Jensen.

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Disclosure

TS receives investigator-initiated research funding and support as principal investigator (R01 AG023178) and co-investigator (R01 AG042845) from the National Institute on Aging, as co-investigator (R01 CA174453) from the National Cancer Institute at the National Institutes of Health, and as principal investigator of a pilot project from the Patient Centered Outcomes Research Institute. He also received research funding as principal investigator of the UNC-DEcIDE center from the Agency for Healthcare Research and Quality. He does not accept personal compensation of any kind from any pharmaceutical company, although he receives salary support from the Center for Pharmacoepidemiology (current members: GlaxoSmithKline, UCB BioSciences and Merck) and research support from pharmaceutical companies (Amgen, Genentech, Merck and Sanofi) to the Department of Epidemiology, University of North Carolina at Chapel Hill. None of the other authors have any disclosures.

Author contributions

ETJ: project conception, design, analyses, interpretation and manuscript draft; JLD: project conception, design, interpretation and critical manuscript review; TS: project design, interpretation and manuscript review; WRR: project design, interpretation and manuscript review; CJW: project design, interpretation and manuscript review; DM: project design and manuscript review; PBJ: project design and manuscript review; KV: project design and manuscript review; PM: project design and manuscript review; MPL: project conception, design, interpretation and critical manuscript review.

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Jensen, E., Daniels, J., Stürmer, T. et al. Maternal hormonal contraceptive use and offspring overweight or obesity. Int J Obes 38, 1275–1281 (2014). https://doi.org/10.1038/ijo.2014.114

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