Evidence map›Paper›PMID 29388678›Full record

SynthesisInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2018

A systematic review and meta-analysis of venous thrombosis risk among users of combined oral contraception.

Monica V Dragoman, Naomi K Tepper, Rongwei Fu, Kathryn M Curtis, Roger Chou, Mary E Gaffield

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 13 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 13 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Guideline
  4. Brazilian Guideline on Menopausal Cardiovascular Health - 2024.Arquivos brasileiros de cardiologia · 2024
    Guideline
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  13. Atencion primaria · 2018
    Guideline
  14. Review
  15. Article
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  19. Article
  20. Oral contraceptive pill phase alters mechanisms contributing to cutaneous microvascular function in response to local heating.American journal of physiology. Regulatory, integrative and comparative physiology · 2025
    Article

7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Monica V DragomanDepartment of Reproductive Health and Research, WHO, Geneva, Switzerland.
Naomi K TepperDivision of Reproductive Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Rongwei FuDepartment of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.
Kathryn M CurtisDivision of Reproductive Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Roger ChouDepartment of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.
Mary E GaffieldDepartment of Reproductive Health and Research, WHO, Geneva, Switzerland.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundCombined oral contraceptives (COCs) containing various progestogens could be associated with differential risks for venous thromboembolism (VTE).

objectiveTo evaluate the comparative risks of VTE associated with the use of low-dose (less than 50 μg ethinyl estradiol) COCs containing different progestogens. SEARCH STRATEGY: PubMed and the Cochrane Library were searched from database inception through September 15, 2016, by combining search terms for oral contraception and venous thrombosis. SELECTION CRITERIA: Studies reporting VTE risk estimates among healthy users of progestogen-containing low-dose COCs were included. DATA COLLECTION AND ANALYSIS: A random-effects model was used to generate pooled adjusted risk ratios and 95% confidence intervals; subgroup and sensitivity analyses assessed the impact of monophasic-COC use and study-level characteristics. MAIN

resultsThere were 22 articles included in the analysis. The use of COCs containing cyproterone acetate, desogestrel, drospirenone, or gestodene was associated with a significantly increased risk of VTE compared with the use of levonorgestrel-containing COCs (pooled risk ratios 1.5-2.0). The analysis restricted to monophasic COC formulations with 30 μg of ethinyl estradiol yielded similar findings. After adjustment for study characteristics, the risk estimates were slightly attenuated.

conclusionsCompared with the use of levonorgestrel-containing COCs, the use of COCs containing other progestogens could be associated with a small increase in risk for VTE.

Indexed as

Contraceptives, Oral, CombinedEthinyl EstradiolFemaleHumansOdds RatioProgestinsRiskVenous ThromboembolismVenous ThrombosisContraceptives, Oral, CombinedEthinyl EstradiolProgestinsCombined oral contraceptivesHormonal contraceptionMeta-analysisRiskSystematic reviewVenous thromboembolism

Identifiers

PMID29388678
PMCPMC5969307

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.