Intest Res 2018; 16(3): 409-415  https://doi.org/10.5217/ir.2018.16.3.409
The association between new generation oral contraceptive pill and the development of inflammatory bowel diseases
Santosh Sanagapalli1, Yanna Ko1, Viraj Kariyawasam1, Siew C Ng2, Whitney Tang2, Hithanadura Janaka de Silva3, Minhu Chen4, Kaichun Wu5, Satimai Aniwan6, Ka Kei Ng7, David Ong8, Qin Ouyang9, Ida Hilmi10, Marcellus Simadibrata11, Pises Pisespongsa12, Saranya Gopikrishna1, Rupert W Leong1, on behalf of the IBD Sydney Organisation and the Asia-Pacific Crohn’s and Colitis Epidemiology Study (ACCESS) Group
1Gastroenterology and Liver Services, Concord Repatriation General Hospital, Concord NSW, Australia, 2Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Hong Kong, China, 3Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka, 4The First Affiliated Hospital of Sun Yat Sen University, Guangzhou, 5Xijing Hospital, Fourth Military Medical University, Xian, China, 6King Chulalongkorn Memorial Hospital, Bangkok, Thailand, 7Hospital Conde S Januario, Macau, China, 8National University Hospital of Singapore, Singapore, 9West China Hospital, Sichuan University, Chengdu, China, 10University of Malaya Medical Center, Kuala Lumpur, Malaysia, 11University of Indonesia, Indonesia, 12Maharaj Nakorn Chiangmai Hospital, Chiangmai, Thailand
Correspondence to: Rupert W Leong, Gastroenterology and Liver Services, Concord Repatriation General Hospital, Concord NSW 2139, Australia. Tel: +61-2-9767-6111, Fax: +61-2-9767-6767, E-mail: rupertleong@outlook.com
Received: November 3, 2017; Revised: February 22, 2018; Accepted: February 28, 2018; Published online: July 30, 2018.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: To examine the association between use of oral contraceptive pills (OCPs) and the risk of developing inflammatory bowel diseases (IBD), in a modern cohort. Methods: A prospective nested case-control study across sites in the Asia-Pacific region was conducted; involving female IBD cases and asymptomatic controls. Subjects completed a questionnaire addressing questions related to OCP use. Primary outcome was the risk of development of IBD of those exposed to OCP versus non-exposure. Secondary outcomes were development of Crohn’s disease (CD) versus ulcerative colitis (UC), and whether age of first use of OCP use may be associated with risk of IBD. Results: Three hundred and forty-eight female IBD cases (41% CD, median age: 43 years) and 590 female age-matched controls were recruited. No significant association was found between OCP use and the risk of IBD (odds ratio [OR], 1.65; 95% confidence interval, 0.77–3.13; P=0.22), CD (OR, 1.55) or UC (OR, 1.01). The lack of association persisted when results were adjusted for age and smoking. IBD cases commenced OCP use at a younger age than controls (18 years vs. 20 years, P=0.049). Conclusions: In this large cohort of subjects from the Asia-Pacific region, we found a modest but not significantly increased risk of developing IBD amongst OCP users.
Keywords: Inflammatory bowel diseases; Contraceptives, oral


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