title: Safety of the etonogestrel-releasing implant during the immediate postpartum period: a pilot study.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University of São Paulo, Ribeirão Preto, School of Medicine, Ribeirão Preto, SP, 14049-900, Brazil.
authors.forename: Milena Bastos
authors.initials: MB
authors.lastname: Brito
authors.forename: Rui Alberto
authors.initials: RA
authors.lastname: Ferriani
authors.forename: Silvana Maria
authors.initials: SM
authors.lastname: Quintana
authors.forename: Marta Edna Holanda Diogenes
authors.initials: ME
authors.lastname: Yazlle
authors.forename: Marcos Felipe
authors.initials: MF
authors.lastname: Silva de Sá
authors.forename: Carolina Sales
authors.initials: CS
authors.lastname: Vieira
mesh_terms: 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
chemical_list: D003271:Contraceptive Agents, Female; D016207:Cytokines; C044815:etonogestrel; D017135:Desogestrel; D002097:C-Reactive Protein; D002784:Cholesterol; D017258:Medroxyprogesterone Acetate