Timing of postpartum etonogestrel-releasing implant insertion and bleeding patterns, weight change, 12-month continuation and satisfaction rates: a randomized controlled trial

Author(s)

Vieira, Carolina Sales ^[1] ; de Nadai, Mariane Nunes ^[1] ; de Melo Pereira do Carmo, Lilian Sheila ^[1] ; Braga, Giordana Campos ^[1] ; Infante, Bruna Fregonesi ^[2] ; Stifani, Bianca M. ^[3] ; Ferriani, Rui Alberto ^[1] ; Quintana, Silvana Maria ^{[1, 2]}

Affiliation

^[1] Univ Sao Paulo, Med Sch Ribeirao Preto, Dept Gynecol & Obstet, Brazil Ave Bandeirantes, 3900 Campus Univ Monte, BR-14049900 Ribeirao Preto, SP - Brazil

^[2] Womens Hlth Reference Ctr Ribeirao Preto, Ave Wanderley Taffo, 330 Quintino Facci II, BR-14070000 Ribeirao Preto, SP - Brazil

^[3] Montefiore Med Ctr, Albert Einstein Coll Med, Gynecol & Womens Hlth, Dept Obstet, 1300 Morris Pk Ave, Bronx, NY 10461 - USA

• Document type: Journal article
• Source: Contraception; v. 100, n. 4, p. 258-263, OCT 2019.
• Web of Science Citations: 0

Abstract

Objectives: To evaluate whether timing of etonogestrel (ENG) implant insertion during the postpartum period affects maternal bleeding patterns, body mass index (BMI) and 12-month satisfaction and continuation rates. Study design: This is a secondary analysis of an open, randomized, controlled trial. Postpartum women were block-randomized to early (up to 48 h postpartum) or delayed (6 weeks postpartum) insertion of an ENG implant. Bleeding patterns and BMI were evaluated every 90 days for 12 months. At 12 months, we measured implant continuation rates and used Likert and face scales to measure users' satisfaction. The level of significance was 0.4% (adjusted by Bonferroni test for multiplicity). Results: We enrolled 100 postpartum women; we randomized 50 to early and 50 to delayed postpartum ENG implant insertion. Bleeding patterns were similar between groups. Amenorrhea rates were high in both groups during the follow-up (52%-56% and 46%-62% in the early and delayed insertion group, respectively). Prolonged bleeding episodes were unusual in both groups during the follow-up (0-2%). Maternal BMI was similar between groups and decreased over time. Twelve-month continuation rates were similar between groups (early insertion: 98% vs. delayed insertion: 100%, p=.99). Most participants were either very satisfied or satisfied with the ENG implant in both groups (p=.9). Conclusion: Women who underwent immediate postpartum insertion of the ENG implant have similar bleeding patterns, BMI changes, and 12-month satisfaction and continuation rates compared to those who underwent delayed insertion. (C) 2019 Elsevier Inc. All rights reserved. (AU)

• FAPESP's process: 13/00795-3 - Effect of the immediately postpartum insertion of the etonogestrel releasing implant on lactation, infant growth and development
• Grantee: Carolina Sales Vieira
• Support Opportunities: Regular Research Grants