Coagulation Profiles Among Combined Oral Contraceptive User and Non-User Women Attending at Family Guidance Association of Ethiopia, Jigjiga Medium Clinic: A Comparative Cross-Sectional Study

Abstract

Introduction: Combined Oral Contraceptives are associated with enhanced procoagulant effects, decreased anticoagulant effects, and equivocal effects on fibrinolysis. The main aim of this study was to compare the mean value of platelet count, PT, and APTT among COC users and non-users and to determine factors associated with coagulopathy among COC users attending Family Guidance Association (FGAE), Jigjiga Medium clinic, Eastern Ethiopia.

Methods: A comparative cross-sectional study was conducted at the FGAE, Jigjiga Medium clinic. A total of 393 women were enrolled using a systematic random sampling method. Socio-demographic and clinical data were obtained via face-to-face interviews and extracted from the medical chart, respectively. To determine PT, APTT, and platelet count, 6.7 milliliters of venous blood was collected. The data were entered into Epi Info version 7.2.4.0 and then transferred to SPSS version 20 for analysis. The Shapiro-Wilk test was used to examine the distribution of the data. Data comparisons between the two groups were conducted using an independent t-test and the Mann-Whitney U-test. To determine factors associated with coagulopathy among COC users, Bivariable and multivariable logistic regression analyses were employed. P-values below 0.05 were regarded as statistically significant.

Results: A sum of 393 subjects (131 COC users and 262 age-matched non-COC-user women) were enrolled in this study. The mean age was 27.67±4.14 (28.12±4.49 years old for COC users and 27.45±3.94 years old for non-COC users. The mean difference indicated that PT and APTT were lower by -1.14 (-1.36,-0.92) and -2.48 (-3.04, -1.91), respectively, in COC user women compared to non-COC users. However, platelet count was significantly elevated in the COC users group (P-value <0.001). The mean ±SD values were 259.5±79.00 and 191.1±27.98 in COC users and non-COC users, respectively. The overall prevalence of coagulopathy was 38.9% (51/131): from this abnormality, 40.5% (53/131) of the COC users showed shortened PT, and 27.5% (36/131) showed shortened APTT. Long-term use of COC (>5 years) was significantly associated with Coagulopathy (AOR = 0.035; 95% CI: 0.004-0.343).

Conclusion: This study showed that COC users exhibited a greater tendency toward hypercoagulability, placing these women at an increased risk of thromboembolic effects compared to COC non-users. There is a high prevalence of coagulopathy among COC users, and long-term usage of COC can lead to hypercoagulation and thrombotic abnormalities.

Keywords: Ethiopia; Jigjiga; coagulopathy; combined oral contraceptive.

Figure 1

Type of coagulopathy identified from COC users.