A comparative study of the levonorgestrel-releasing intrauterine system Mirena versus the Copper T380A intrauterine device during lactation: breast-feeding performance, infant growth and infant development.
BACKGROUND
Mirena is a levonorgestrel-releasing intrauterine system (LNG-IUS) that provides highly effective and long-acting progestogen-only contraception.


OBJECTIVE
The objective of this study was to analyze the possible effects of using LNG-20 microg IUS on breast-feeding performance, infant growth and infant development during the first postpartum year as compared with the Copper T380A intrauterine device (Cu T380A IUD).


METHODS
This study is a prospective, controlled and randomized trial.


METHODS
The study was conducted at the Department of Obstetrics and Gynecology, Assiut University Hospital, Egypt.


METHODS
Three hundred twenty lactating women asking for initiation of contraception during the early postpartum stage were assigned randomly into two groups, the LNG-20 microg IUS group (n=163) and the Cu T380A group (n=157). The insertions were done 6-8 weeks postpartum. Each participant was followed up at three monthly intervals after insertion and until the first birthday of her baby. During these visits, the breast-feeding pattern was assessed, certain infant physical growth parameters were measured and a set of infant development tests was performed.


RESULTS
No pregnancy occurred in both groups. There were no significant differences in the net continuation rates between the two groups (89.3 for LNG-IUS vs. 90.9 for Cu T380A). The LNG-20 microg IUS group had comparable rates of breast-feeding continuation, complete weaning, full breast-feeding and partial breast-feeding, with the Cu-IUD group. No statistically significant differences were found between groups with regard to all infant physical growth parameters and various infant development tests.


CONCLUSIONS
The findings of the current study confirm that the use of LNG-20 microg IUS during the first postpartum year in lactating women provides highly effective and acceptable contraception and does not negatively influence breast-feeding or the growth and development of breast-fed infants.
Shaamash
Ayman H
AH
Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt. shamaashayman@yahoo.com
Sayed
Gamal H
GH
Hussien
Mostafa M
MM
Shaaban
Mamdouh M
MM
D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D002657:Child Development / Q000187:drug effects* / Q000502:physiology; D003271:Contraceptive Agents, Female / Q000009:adverse effects / Q000494:pharmacology*; D004534:Egypt; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007435:Intrauterine Devices, Copper / Q000009:adverse effects*; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects*; D007774:Lactation / Q000187:drug effects*; D016912:Levonorgestrel / Q000009:adverse effects / Q000494:pharmacology*; D008297:Male; D011446:Prospective Studies
D003271:Contraceptive Agents, Female; D016912:Levonorgestrel