THE RISKS OF VENOUS THROMBOEMBOLIC DISEASE AMONG GERMAN WOMEN USING ORAL-CONTRACEPTIVES - A DATABASE STUDY

This study investigated the risk of venous thromboembolic disease (VTE ) between second and third generation combined oral contraceptives, us ing the German MediPlus database of patient records. Women studied inc luded 42 patients between the ages of 18 and 49 years, with a diagnosi s of VTE treated with an anticoagulant, who were exposed to an oral co ntraceptive (OC). Four controls per patient (168), matched by year of birth and exposure to an QC on the event day, were identified. More wo men were users of second generation than third generation OC, and none were using progestogen-only pills. There was no significant differenc e between patients and control subjects with respect to the type of OC used on the event day (unadjusted odds ratio for third versus second generation users was 0.77; 95% confidence interval [CI] 0.38-1.57) The re was no significant age difference between second and third generati on users among patients or control subjects. Between January 1 and the Event date, there was no significant difference between the patients and control subjects in terms of the number of oral contraceptive pres criptions, number of consultations for psychotherapeutic complaints, o r mixed physical and psychotherapeutic consultations; however, patient s did demonstrate significantly more consultations for purely physical complaints compared with control subjects ip <0.0001). There were no significant consultation differences between patients with pulmonary e mboli (n = 6) and other VTE patients (n = 36). No significant differen ces with respect to VTE risk between users of second and third generat ion oral contraceptives were found in this study. Consultations (physi cal) for patients were higher than for control subjects before the VTE event. If consultation rate relates to the general health status of a pel son, this might indicate that VTE risk is higher among women of p oorer health, but that this is not related to the type of progestogen in the oral contraceptive that they use. (C) 1998 Elsevier Science Inc . All rights reserved.