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Exogenous female sex steroid hormones and new-onset asthma in women: a matched case–control study

Zhang, Guoqiang ; Basna, Rani LU orcid ; Mathur, Maya b. ; Lässer, Cecilia ; Mincheva, Roxana ; Ekerljung, Linda ; Wennergren, Göran ; Rådinger, Madeleine ; Lundbäck, Bo and Kankaanranta, Hannu , et al. (2023) In BMC Medicine 21(1).
Abstract
Background
Evidence on the role of exogenous female sex steroid hormones in asthma development in women remains conflicting. We sought to quantify the potential causal role of hormonal contraceptives and menopausal hormone therapy (MHT) in the development of asthma in women.
Methods
We conducted a matched case–control study based on the West Sweden Asthma Study, nested in a representative cohort of 15,003 women aged 16–75 years, with 8-year follow-up (2008–2016). Data were analyzed using Frequentist and Bayesian conditional logistic regression models.
Results
We included 114 cases and 717 controls. In Frequentist analysis, the odds ratio (OR) for new-onset asthma with ever use of hormonal contraceptives was 2.13 (95%... (More)
Background
Evidence on the role of exogenous female sex steroid hormones in asthma development in women remains conflicting. We sought to quantify the potential causal role of hormonal contraceptives and menopausal hormone therapy (MHT) in the development of asthma in women.
Methods
We conducted a matched case–control study based on the West Sweden Asthma Study, nested in a representative cohort of 15,003 women aged 16–75 years, with 8-year follow-up (2008–2016). Data were analyzed using Frequentist and Bayesian conditional logistic regression models.
Results
We included 114 cases and 717 controls. In Frequentist analysis, the odds ratio (OR) for new-onset asthma with ever use of hormonal contraceptives was 2.13 (95% confidence interval [CI] 1.03–4.38). Subgroup analyses showed that the OR increased consistently with older baseline age. The OR for new-onset asthma with ever MHT use among menopausal women was 1.17 (95% CI 0.49–2.82). In Bayesian analysis, the ORs for ever use of hormonal contraceptives and MHT were, respectively, 1.11 (95% posterior interval [PI] 0.79–1.55) and 1.18 (95% PI 0.92–1.52). The respective probability of each OR being larger than 1 was 72.3% and 90.6%.
Conclusions
Although use of hormonal contraceptives was associated with an increased risk of asthma, this may be explained by selection of women by baseline asthma status, given the upward trend in the effect estimate with older age. This indicates that use of hormonal contraceptives may in fact decrease asthma risk in women. Use of MHT may increase asthma risk in menopausal women. (Less)
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publishing date
type
Contribution to journal
publication status
published
keywords
Bayesian analysis
in
BMC Medicine
volume
21
issue
1
article number
337
publisher
BioMed Central (BMC)
external identifiers
  • pmid:37667254
  • scopus:85169693998
ISSN
1741-7015
DOI
10.1186/s12916-023-03038-8
language
English
LU publication?
no
id
a9955076-b337-4e73-ba1b-e10250e9df41
date added to LUP
2024-05-31 18:22:46
date last changed
2024-06-03 08:18:39
@article{a9955076-b337-4e73-ba1b-e10250e9df41,
  abstract     = {{Background<br/>Evidence on the role of exogenous female sex steroid hormones in asthma development in women remains conflicting. We sought to quantify the potential causal role of hormonal contraceptives and menopausal hormone therapy (MHT) in the development of asthma in women.<br/>Methods<br/>We conducted a matched case–control study based on the West Sweden Asthma Study, nested in a representative cohort of 15,003 women aged 16–75 years, with 8-year follow-up (2008–2016). Data were analyzed using Frequentist and Bayesian conditional logistic regression models.<br/>Results<br/>We included 114 cases and 717 controls. In Frequentist analysis, the odds ratio (OR) for new-onset asthma with ever use of hormonal contraceptives was 2.13 (95% confidence interval [CI] 1.03–4.38). Subgroup analyses showed that the OR increased consistently with older baseline age. The OR for new-onset asthma with ever MHT use among menopausal women was 1.17 (95% CI 0.49–2.82). In Bayesian analysis, the ORs for ever use of hormonal contraceptives and MHT were, respectively, 1.11 (95% posterior interval [PI] 0.79–1.55) and 1.18 (95% PI 0.92–1.52). The respective probability of each OR being larger than 1 was 72.3% and 90.6%.<br/>Conclusions<br/>Although use of hormonal contraceptives was associated with an increased risk of asthma, this may be explained by selection of women by baseline asthma status, given the upward trend in the effect estimate with older age. This indicates that use of hormonal contraceptives may in fact decrease asthma risk in women. Use of MHT may increase asthma risk in menopausal women.}},
  author       = {{Zhang, Guoqiang and Basna, Rani and Mathur, Maya b. and Lässer, Cecilia and Mincheva, Roxana and Ekerljung, Linda and Wennergren, Göran and Rådinger, Madeleine and Lundbäck, Bo and Kankaanranta, Hannu and Nwaru, Bright i.}},
  issn         = {{1741-7015}},
  keywords     = {{Bayesian analysis}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Medicine}},
  title        = {{Exogenous female sex steroid hormones and new-onset asthma in women: a matched case–control study}},
  url          = {{http://dx.doi.org/10.1186/s12916-023-03038-8}},
  doi          = {{10.1186/s12916-023-03038-8}},
  volume       = {{21}},
  year         = {{2023}},
}