The Association Between Contraceptive Use at the Time of Conception and Hypertensive Disorders During Pregnancy: A Retrospective Cohort Study of Prams Participants

Each year approximately 7 % of women experience hypertensive disorders during pregnancy which can result in adverse events for both the mother and child. Previous research suggests that contraception at the time of conception can also predispose one to hypertensive disorders during pregnancy. The objective of this study was to examine the association between contraceptive use at the time of conception and hypertensive complications during pregnancy. A total of 2,395 women aged 18-45 years participated in the 2007-2009 Michigan Pregnancy Risk Assessment Monitoring System. Contraception at the time of conception was self-reported by participants and classified as barrier, nonbarrier, or non-use. Information on hypertensive disorders during pregnancy was primarily from birth certificates. Logistic regression was used to obtain odds ratios (ORs) and 95 % confidence intervals (CIs) to model the contraception-hypertensive disorder association. After adjustment for age and race/ethnicity, there was no strong association between use of barrier contraception at the time of conception and hypertensive disorders during pregnancy as compared to non-users (OR 1.09, 95 % CI 0.62-1.92). After adjustment for the same variables, nonbarrier users had 1.22 times the odds of experiencing hypertensive disorders during pregnancy as compared to non-users (95 % CI 0.75-1.98). Although we did not find an association between contraceptive use at the time of conception and hypertensive disorders during pregnancy, additional studies with larger sample sizes and more explicit categorization of the outcome variable are needed to confirm these findings.