SynthesisPloS one2026
Safety and effectiveness of hormonal vs non-hormonal or no contraception in women with hypertension and future fertility desire: A broad-scope systematic review.
Synthesis in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the safety and effectiveness of hormonal contraceptives compared to non-hormonal methods or no contraception in hypertensive women seeking future fertility. DATA SOURCES: Searches were conducted in Medline, Embase, CENTRAL, and LILACS (September -October, 2022), with updates on September, 2023, and August, 2024. Clinical trial records, regulatory agencies, and gray literature were also consulted (June, 2022; August, 2023; September, 2024).
methodsEligible studies that assessed safety (major adverse cardiovascular events, pelvic inflammatory disease, vaginal infections, loss of fertility, discontinuation, worsening hypertension, peripheral arterial disease, venous thromboembolism, weight gain, liver or kidney function changes) or effectiveness (pregnancies/Pearl index) of hormonal contraceptives in hypertensive women. Eligible designs included clinical trials, cohort and case control studies, case series, case reports, and adverse event data. Two reviewers independently screened titles/abstracts, reviewed full texts, selected studies, extracted data, and assessed bias (ROBINS-I: cohorts), methodological quality (Newcastle Ottawa: case-control), and critical appraisal (Joanna Briggs Institute: case series). Certainty of evidence was evaluated using GRADE. Evidence was synthesized quantitatively and qualitatively by contraceptive and outcome.
resultsOf 32,225 records screened, 17 studies were included. Combined oral contraceptives may increase hemorrhagic cerebrovascular disease (OR: 1.64 (95% CI 1.08-2.50, certainty: low). Evidence is very uncertain about their effects on preventing pregnancies, and safety related to ischemic cerebrovascular disease, myocardial infarction, venous thromboembolism, weight gain, hypertension, kidney function, and lipid profile. Similarly, the effects of progestin-only pills, injectables, and vaginal rings on cardiovascular and metabolic outcomes remain highly uncertain. Certainty is also very low for combined oral contraceptives or progestogen-only pills regarding cerebrovascular disease, myocardial infarction (OR: 1.15, 95% CI 0.60-2.19), and peripheral arterial disease.
conclusionsLow-certainty evidence suggests that combined oral contraceptives may increase hemorrhagic cerebrovascular disease in hypertensive women, whereas evidence for the other assessed safety and effectiveness outcomes is very low.
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Registered trials
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.