Etonogestrel-Releasing Contraceptive Implant for Postpartum Adolescents: A Randomized Controlled Trial

Amy G. Bryant, Anna E. Bauer, Gretchen S. Stuart, Erika E. Levi, Matthew L. Zerden, Antoinette Danvers, Joanne M. Garrett

Research output: Contribution to journalArticle

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Abstract

Study Objective To compare immediate postpartum insertion of the contraceptive implant to placement at the 6-week postpartum visit among adolescent and young women. Design Non-blinded, randomized controlled trial. Setting and Participants 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. Interventions Placement of an etonogestrel-releasing contraceptive implant before leaving the hospital postpartum, or at the 4-6 week postpartum visit. Main Outcome Measures 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). Conclusion 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.

LanguageEnglish (US)
Pages389-394
Number of pages6
JournalJournal of Pediatric and Adolescent Gynecology
Volume30
Issue number3
DOIs
StatePublished - Jun 1 2017

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Contraceptive Agents
Postpartum Period
Randomized Controlled Trials
etonogestrel
Urban Population
Rural Population
Tertiary Healthcare
Breast Feeding
Contraception
Tertiary Care Centers
Outcome Assessment (Health Care)

Keywords

  • Adolescent
  • Contraceptive implant
  • LARC
  • Long-acting reversible contraception
  • Postpartum
  • Rapid repeat pregnancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Etonogestrel-Releasing Contraceptive Implant for Postpartum Adolescents : A Randomized Controlled Trial. / Bryant, Amy G.; Bauer, Anna E.; Stuart, Gretchen S.; Levi, Erika E.; Zerden, Matthew L.; Danvers, Antoinette; Garrett, Joanne M.

In: Journal of Pediatric and Adolescent Gynecology, Vol. 30, No. 3, 01.06.2017, p. 389-394.

Research output: Contribution to journalArticle

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abstract = "Study Objective To compare immediate postpartum insertion of the contraceptive implant to placement at the 6-week postpartum visit among adolescent and young women. Design Non-blinded, randomized controlled trial. Setting and Participants 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. Interventions Placement of an etonogestrel-releasing contraceptive implant before leaving the hospital postpartum, or at the 4-6 week postpartum visit. Main Outcome Measures 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). Conclusion 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.",
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