American Journal of Epidemiology Vol. 134, No. 8: 795-803
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health
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In Utero Exposure to Steroid Contraceptives and Outcome of Pregnancy
1Department of Community Medicine, University of Chiang Mai Chiang Mai, Thailand
2Department of Population Dynamics, The Johns Hopkins University School of Hygiene and Public Health Baltimore, MD
Repint requests to Dr Ronald H Gray, Department of Population Dynamics, The Johns Hopkins University School of Hygiene and Public Health, 615 North Wolfe Street, Baltimore, MD 21205
A cohort study of women who used steroid contraceptives during pregnancy was conducted in Chiang Mai, northern Thailand, between 1984 and 1987 There were 1, 573 pregnancies in which the fetus was exposed to the injectable contraceptive Depo-Provera® (The Upjohn Company, Kalamazoo, Michigan) (830 accidental pregnancies and 743 infants conceived before the mother started use of Depo-Provera), 601 accidental pregnancies in women who were using oral contraceptives, and 2, 578 planned pregnancies with no steroid exposures (controls). Subjects were followed up for interview, and medical records were traced for birth weight Women using Depo-Provera had more risk factors for adverse pregnancy outcomes than did the other groups. The adjusted odds ratios for low birth weight were increased for accidental pregnancies with fetal exposure to Depo-Provera (odds ratio (OR) = 1.5, 95% confidence interval (Cl) 1.2–1.9) or oral contraceptives (OR = 1.5, 95% Cl 1.2–2 0) The higher risk of low birth weight among infants exposed in utero to Depo-Provera or oral contraceptives is due in part to self-selection for adverse outcomes among women with unplanned pregnancies. However, among accidental pregnancies with Depo-Provera, the nsk of low birth weight was significantly increased when conception was estimated to have occurred within 4 weeks of injection. The odds ratios were 1.9 (95% Cl 1.4–3.2) for injection-to-conception intervals of 4 weeks, 1.5 (95% Cl 0.9–2.3) for intervals of 5–8 weeks, and 1.2 (95% Cl 0.7–1.9) for intervals of 
9 weeks. This trend was highly significant. Thus, the authors conclude that early, high-dose in utero exposures to Depo-Provera may affect fetal growth.
contraceptive agents; contraceptives, oral; infant, low birth weight; medroxy-progesterone; pregnancy outcome
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  H. Ahn, J. Choi, J. Han, M. Kim, J. Chung, H. Ryu, M. Kim, J. Yang, M. Koong, A. Nava-Ocampo, et al. Pregnancy outcome after exposure to oral contraceptives during the periconceptional period Human and Experimental Toxicology, April 1, 2008; 27(4): 307 - 313. [Abstract] [PDF]
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