Effect of Hormonal Contraception on Kidney Outcomes in Females: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: Over 70% of reproductive-aged females in Canada use contraception. Previous literature demonstrates that hormonal contraception has important implications for cardiovascular health, but its effect on kidney health outcomes is poorly understood. Therefore, this systematic review and meta-analysis aimed to determine the effect of hormonal contraception on kidney outcomes in females. Methods: A literature search of MEDLINE, Embase, and CENTRAL (from database inception-November 2021) was developed and reviewed by a health librarian, to identify original studies that reported kidney health outcomes (e.g., kidney function, proteinuria, progression or development of chronic kidney disease or kidney failure) in female hormonal contraception users. Two independent reviewers evaluated articles, extracted data, and assessed study quality in duplicate using the National Institutes of Health Study Quality Assessment Tools. Outcome measures were reported as weighted mean differences and meta-analyzed using a random effects model. Heterogeneity was assessed with the I2 statistic. A stratified meta-analysis by type of hormonal contraception (oral vs other) was conducted for the outcome of change in serum creatinine. Results: Of the 10,350 references identified within the search strategy, 18 observational studies were included, and 14 were eligible for meta-analysis. Most studies reported on oral contraceptives (N=14). Meta-analyses revealed no difference in mean serum creatinine [0.00 mg/dL (95% CI: -0.05, 0.05); I2=68.5%], creatinine clearance [10.01 mL/min (95% CI: -1.48, 21.50); I2=90.6%], and estimated glomerular filtration rate [0.37 mL/min/1.73m2 (95% CI: -8.77, 9.51); I2=37.1%] between hormonal contraception users and non-users. When stratified by type of hormonal contraception, the overall pooled estimate also showed no difference in serum creatinine between groups. Overall study quality was fair. Conclusions: This systematic review and meta-analysis found no association between hormonal contraception and various kidney outcomes. While the included studies had significant limitations and heterogeneity, this highlights the need for rigorous prospective studies examining the effect of hormonal contraception on kidney outcomes in females. Funding: Government Support - Non-U.S.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.014 | 0.007 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".