In a Danish nationwide cohort study reported in JAMA, Hargreave et al found no association between maternal hormonal contraception use and risk of central nervous system (CNS) tumors in children.
As stated by the investigators, “The incidence of CNS tumors in children appears to be increasing, yet few risk factors are established. There is limited information regarding whether maternal hormonal contraception use increases this risk.”
Study Details
In the study, based on population-based registry data, 1,185,063 children born in Denmark between January 1996 and December 2014 were followed for a diagnosis of a CNS tumor before the age of 20 years, with final follow-up in December 2018. Maternal hormonal contraception use was analyzed according to any use, regimen (combined/progestin only), and route of administration (oral/nonoral). Use was also categorized as recent (≤ 3 months before start and during pregnancy), previous (> 3 months before start of pregnancy), and no use.
Key Findings
After 15,335,990 person-years of follow-up (mean follow-up = 12.9 years), 725 children were diagnosed with a CNS tumor, with a mean age of 7 years at diagnosis.
The adjusted incidence rate of CNS tumors per 100,000 person-years was 5.3 for children (n = 220) born to mothers (n = 270,198) with no hormonal contraception use. In comparison, rates were 5.0 for children (n = 84) born to mothers (n = 136,022) with recent use (hazard ratio [HR] = 0.95, 95% confidence interval [CI] = 0.74–1.23; incidence rate difference = −0.3, 95% CI = −1.6 to 1.0) and 4.5 for children (n = 421) born to mothers (n = 778,843) with previous use (HR = 0.86, 95% CI = 0.72–1.02; incidence rate difference = −0.8, 95% CI = −1.7 to 0.0).
No significant differences in risk between recent or previous use vs no use were observed for use of oral combined, nonoral combined, oral progestin only, or nonoral contraception products.
The investigators concluded, “Among Danish children, there was no statistically significant association between any maternal hormonal contraception use and CNS tumor risk.”
Marie Hargreave, PhD, of Virus, Lifestyle and Genes, Danish Cancer Society, Copenhagen, is the corresponding author for the JAMA article.
Disclosure: The study was supported by the Danish Cancer Research Foundation, Arvid Nilssons Foundation, Gangsted Foundation, and others. For full disclosures of the study authors, visit jamanetwork.com.
