Year: 2018
Type: article
Study design: Clinical Trial
Abstract: Objectives: To investigate the impact of the etonogestrel implant (ENG-IMP) and depot-medroxyprogesterone acetate (DMPA) on weight loss in non-breastfeeding women during the first postpartum year. Study Design:We designed a modified randomized controlled trial of immediately postpartum, non-breastfeeding women.Sixty six women were randomized to receive either the ENG-IMP or DMPA prior to discharge from the hospital.Thirty four women choosing to leave the hospital without initiating a contraceptive method served as a comparison group.The primary outcome of weight loss, both absolute and percent, was computed, and compared among groups over time during the first postpartum year.Secondary outcomes included contraceptive continuation and satisfaction.Results: At 3 months postpartum, mean weight loss for ENG-IMP users was 8.1% (6.5 kg), DMPA users lost 2.2% (2.0 kg), and the comparison group lost 8.2% (6.5 kg).The difference in percent weight change at 3 months between DMPA users and both ENG-IMP users and the comparison group was statistically significant (p=0.007,p=0.02 respectively).At 6 and 12 months, there were no statistically significant weight loss differences between groups.Randomized women had high rates of satisfaction ("good" or "very good" for 88% of ENG-IMP users, and 89% of DMPA users) and continuation (89% of ENG-IMP and 73% of DMPA users) at 12 months.Conclusions: By three months postpartum, women using the ENG-IMP had lost more weight than DMPA users, but the difference was not sustained at 12 months.Implications: Providers should inform women not breastfeeding in the postpartum period that early administration of DMPA may decrease initial weight loss relative to implant users and those getting DMPA later, though weight loss at 12 months postpartum may be the same among all groups.This study highlights the relatively small weight losses in the postpartum period among all groups and indicates the need for education and programs to encourage postpartum weight loss in this population.
Institutions: Planned Parenthood, University of Pennsylvania
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2800901551