Assoziationen zwischen der Einnahme oraler Kontrazeptiva und hämatologischen Parametern bei weiblichen Jugendlichen

Associations between taking oral contraceptives and haematological parameters in adolescents

by Sabina Lewandowski
Doctoral thesis
Date of Examination:2020-10-05
Date of issue:2020-09-08
Advisor:Prof. Dr. Thomas Meyer
Referee:PD Dr. Julie Schanz
Referee:Prof. Dr. Rainer Mausberg
Persistent Address: http://dx.doi.org/10.53846/goediss-8162

 

 

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Abstract

English

In this post-hoc analysis, the influence of oral contraceptives on haematological parameters in n = 2775 female German adolescents aged between 13 and 17 years was examined. Data from the nationwide representative Child and Youth Health Survey (KiGGS) of the Robert Koch institute in the years 2003 to 2006 were used. The cross-sectional KiGGS study used standardized and well-validated procedures and provided a large, unbiased data including self- and parents-rated assessment questionnaires. In addition, values of clinical laboratory parameters were recorded, which were collected from blood samples. In the descriptive analysis, it was found that girls aged 13 to 17 increasingly used contraceptives with age, up to 45% in the last birth year. In addition, girls without a migrant background showed a higher frequency of contraceptive use compared to migrants (22.0% versus 7.5%, p <0.001). Regardless of oral contraceptive use, there was a positive correlation between serum 25(OH) vitamin D and MCV (r = 0.136, p <0.001) and MCH (r = 0.047, p = 0.043), respectively. In contrast, serum 25(OH) vitamin D correlated negatively with the following parameters: RBC (r = -0.072, p = 0.002), MCHC (r = -0.111, p <0.001), sTfR (r = -0.123, p <0.001) and vitamin B12 (r = -0.058, p = 0.014). In multivariate regression analysis, iron (β = 0.022; 95%-CI = 1.001 – 1.045; p = 0.043), soluble transferrin receptor (sTfR; β = -3.472; 95%-CI = 0.003 – 0.282; p = 0.002) and MCV (β = -0.053; 95%-CI = 0.907 – 0.992; p = 0.022) were all significant predictors of contraceptive use in separate models. In another regression model, which was additively adjusted with the lipids as confounders, a significant difference in the parameter soluble transferrin receptor (sTfR; β = -3.397; 95%-CI = 0.003 – -0.324; p = 0.003) was detected. The results of this work suggest a hormonal influence of the use of oral contraceptives on erythropoiesis. Further epidemiological studies in independent cohorts and additional experimental studies with biochemical methodology are needed to confirm the above observations and to identify the suspected mechanism of action.
Keywords: Oral contraceptive use; Hormonal contraception; Adolescents
 
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