Safety of the etonogestrel-releasing implant during the immediate postpartum period: a pilot study.
BACKGROUND
The effects of etonogestrel (ETG)-releasing contraceptive implant during the immediate postpartum period on maternal safety are unknown.


METHODS
Forty healthy women exclusively breastfeeding were randomized to receive either ETG-releasing implant 24-48 h after delivery (n=20) or depot medroxyprogesterone acetate (DMPA group; n=20) at the sixth week postpartum. We measured blood pressure, maternal and neonatal weight, body mass index (BMI; kg/m(2)), waist circumference (WC), complete blood count, C-reactive protein, interleukin-6, tumor necrosis factor (TNF-alpha), lipid profile, fasting serum glucose and maintenance of exclusive lactation up to the 12th week postpartum.


RESULTS
Decreases in mean maternal weight, BMI (kg/m(2)) and WC were significantly greater in the ETG-releasing implant group than in the DMPA group during the first 6 weeks postpartum (-4.64+/-2.71 kg vs. -2.6+/-2.45 kg mean+/-SD, p=.017; -1.77+/-1.06 kg/m(2) vs. -0.97+/-0.95 kg/m(2), p=.026; -15.3+/-6.72 cm vs. -9.05+/-5.84 cm, p=.003, respectively). In addition, total cholesterol and HDL, were lower in DMPA users, and TNF-alpha and leukocytes were higher in DMPA users compared to in the implant group, between 6 and 12 weeks after delivery. The newborns of implant users showed a trend towards gaining more weight, as compared with the infants of the DMPA mothers during the first 6 weeks of life (implant group: +1460.50+/-621.34 g vs. DMPA group: +1035.0+/-562.43 g, p=.05). The remaining variables, including the duration of exclusive breastfeeding, were similar between the groups.


CONCLUSIONS
The insertion of ETG-releasing contraceptive implant during the immediate postpartum period was not associated with deleterious maternal clinical effects or with significant maternal metabolic alterations or decreased infant weight gain.
Brito
Milena Bastos
MB
Department of Obstetrics and Gynecology, University of São Paulo, Ribeirão Preto, School of Medicine, Ribeirão Preto, SP, 14049-900, Brazil.
Ferriani
Rui Alberto
RA
Quintana
Silvana Maria
SM
Yazlle
Marta Edna Holanda Diogenes
ME
Silva de Sá
Marcos Felipe
MF
Vieira
Carolina Sales
CS
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001772:Blood Cell Count; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D002097:C-Reactive Protein / Q000378:metabolism; D016009:Chi-Square Distribution; D002784:Cholesterol / Q000097:blood; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects; D016207:Cytokines / Q000097:blood; D017135:Desogestrel / Q000008:administration & dosage / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation / Q000187:drug effects*; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000009:adverse effects; D018579:Patient Selection; D010865:Pilot Projects; D018709:Statistics, Nonparametric; D055105:Waist Circumference / Q000187:drug effects
D003271:Contraceptive Agents, Female; D016207:Cytokines; C044815:etonogestrel; D017135:Desogestrel; D002097:C-Reactive Protein; D002784:Cholesterol; D017258:Medroxyprogesterone Acetate