title: Etonogestrel-Releasing Contraceptive Implant for Postpartum Adolescents: A Randomized Controlled Trial.
abstract: OBJECTIVE
  To compare immediate postpartum insertion of the contraceptive implant to placement at the 6-week postpartum visit among adolescent and young women.
  
  
  METHODS
  Non-blinded, randomized controlled trial.
  
  
  METHODS
  Postpartum adolescents and young women ages 14-24 years who delivered at an academic tertiary care hospital serving rural and urban populations in North Carolina.
  
  
  METHODS
  Placement of an etonogestrel-releasing contraceptive implant before leaving the hospital postpartum, or at the 4-6 week postpartum visit.
  
  
  METHODS
  Contraceptive implant use at 12 months postpartum.
  
  
  RESULTS
  Ninety-six participants were randomized into the trial. Data regarding use at 12 months were available for 64 participants, 37 in the immediate group and 27 in the 6-week group. There was no difference in use at 12 months between the immediate group and the 6-week group (30 of 37, 81% vs 21 of 27, 78%; P = .75). At 3 months, the immediate group was more likely to have the implant in place (34 of 37, 92% vs 19 of 27, 70%; P = .02).
  
  
  CONCLUSIONS
  Placing the contraceptive implant in the immediate postpartum period results in a higher rate of use at 3 months postpartum and appears to have similar use rates at 12 months compared with 6-week postpartum placement. Providing contraceptive implants to adolescents before hospital discharge takes advantage of access to care, increases the likelihood of effective contraception in the early postpartum period, appears to have no adverse effects on breastfeeding, and might lead to increased utilization at 1 year postpartum.
authors: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: amy_bryant@med.unc.edu.
authors: Amy G
authors: AG
authors: Bryant
authors: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Anna E
authors: AE
authors: Bauer
authors: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Gretchen S
authors: GS
authors: Stuart
authors: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Erika E
authors: EE
authors: Levi
authors: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Matthew L
authors: ML
authors: Zerden
authors: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Antoinette
authors: A
authors: Danvers
authors: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors: Joanne M
authors: JM
authors: Garrett
mesh_terms: D000293:Adolescent; D000328:Adult; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000009:adverse effects / Q000627:therapeutic use*; D017135:Desogestrel / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D009657:North Carolina; D049590:Postpartum Period; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; C044815:etonogestrel; D017135:Desogestrel
keywords: Adolescent; Contraceptive implant; LARC; Long-acting reversible contraception; Postpartum; Rapid repeat pregnancy