title: Association of body mass index with removal of etonogestrel subdermal implant.
abstract: BACKGROUND
  Bleeding irregularities represent the most common etonogestrel subdermal implant (ESI) removal indication.
  
  
  METHODS
  ESI placements (n=304) from June 2007 to April 2011 were grouped by removal indications. Group characteristics were compared using one-way analysis of variance, Kruskal-Wallis and χ(2) test.
  
  
  RESULTS
  Of 304 insertions, 30.6% reported irregular bleeding. Removal indications included bleeding (Group 1, n=50), side effects (Group 2, n=17) and desired pregnancy/no need (Group 3, n=25). Group 4 kept (n=198) or reinserted (n=14) ESI. Median body mass index was lower for Group 1 compared to other groups (p=.012). Group 3 was older than Group 1 or 4 (p=.021), and more likely parous (p<.001) and postpartum (p=.001) than other groups. Lactational placement was more common in Group 3 than 4 (p<.001). Obese women were 2.6 times less likely to remove ESI for bleeding vs. normal-weight or overweight women (95% confidence interval, 1.2-5.7; p=.014).
  
  
  CONCLUSIONS
  After adjusting for age and parity, obese women were less likely to have ESI removal for bleeding.
authors.affiliation: Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USA. Casey.petra@mayo.edu
authors.forename: Petra M
authors.initials: PM
authors.lastname: Casey
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Long
authors.forename: Mary L
authors.initials: ML
authors.lastname: Marnach
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fleming-Harvey
authors.forename: Linda B
authors.initials: LB
authors.lastname: Drozdowicz
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D017135:Desogestrel / Q000008:administration & dosage / Q000009:adverse effects*; D020878:Device Removal / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008599:Menstruation Disturbances / Q000139:chemically induced*; D008875:Middle Aged; D012189:Retrospective Studies; D014592:Uterine Hemorrhage / Q000139:chemically induced; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; C044815:etonogestrel; D017135:Desogestrel