title: Maternal hormonal contraceptive use and offspring overweight or obesity.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: 1] Department of Epidemiology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA [2] Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: E T
authors.initials: ET
authors.lastname: Jensen
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Daniels
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: T
authors.initials: T
authors.lastname: Stürmer
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: W R
authors.initials: WR
authors.lastname: Robinson
authors.affiliation: Department of Epidemiology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Williams
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
authors.forename: D
authors.initials: D
authors.lastname: Moster
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: P B
authors.initials: PB
authors.lastname: Juliusson
authors.affiliation: Division of Epidemiology, National Institute of Public Health, Oslo, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Vejrup
authors.affiliation: Division of Epidemiology, National Institute of Public Health, Oslo, Norway.
authors.forename: P
authors.initials: P
authors.lastname: Magnus
authors.affiliation: Department of Epidemiology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Longnecker
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003271:Contraceptive Agents, Female / Q000009:adverse effects* / Q000494:pharmacology; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D063766:Pediatric Obesity / Q000139:chemically induced* / Q000453:epidemiology; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000453:epidemiology; D011446:Prospective Studies
chemical_list: D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal