TY - JOUR
T1 - Postpartum weight loss in overweight and obese women using the etonogestrel subdermal implant
T2 - a pilot study
AU - Griffin, Leanne
AU - Hammond, Cassing
AU - Liu, Dachao
AU - Rademaker, Alfred W.
AU - Kiley, Jessica
PY - 2017/6
Y1 - 2017/6
N2 - Objective To compare weight loss during the first 6 months postpartum in overweight and obese women using the etonogestrel implant, placed in the immediate postpartum period, with that of controls using nonhormonal contraception, utilizing a pilot design. Study design Pilot, prospective cohort study. Analysis groups were divided by body mass index (overweight: 25–29.9 kg/m2; Class I Obesity: 30–34.5 kg/m2; Class II Obesity: 35–39.9 kg/m2) and grouped by use of etonogestrel implant or nonhormonal contraception for all outcomes. Primary outcome was the proportion of women in each group returning to pregravid weight by 6 months postpartum. Secondary outcomes included waist circumference, motivation to lose weight, eating habits, physical activity, feasibility of study procedures and assessment of recruitment potential in the first 6 months postpartum. Results A total of 127 women enrolled between June 2014 and August 2015. Fifty-seven chose the etonogestrel implant for immediate postpartum contraception while 70 chose nonhormonal contraceptives. Six months after delivery, about half of women in each group returned to within 1.5 kg of pregravid weight (42% etonogestrel [ENG]-implant vs. 67% nonhormonal methods, p=.19). Retention rates were high with over 75% of total study population providing study data at 6 months. Two nonhormonal contraceptive users conceived in the first 4 months postpartum. Conclusion No statistical difference in percentage return to pregravid weight was detected between groups, but data suggest that a somewhat lower proportion of implant users lost weight at 6 months. Rapid recruitment, high retention and marked acceptance of immediate ENG implant use demonstrate feasibility for a larger, adequately powered trial. Implications Immediate postpartum insertion of the ENG implant is safe and effective. Study findings suggest modest interference in overweight and obese women's ability to lose gestational weight. If future research demonstrates no statistical difference, increased uptake in immediate implant use should occur in most women, including those who are overweight or obese.
AB - Objective To compare weight loss during the first 6 months postpartum in overweight and obese women using the etonogestrel implant, placed in the immediate postpartum period, with that of controls using nonhormonal contraception, utilizing a pilot design. Study design Pilot, prospective cohort study. Analysis groups were divided by body mass index (overweight: 25–29.9 kg/m2; Class I Obesity: 30–34.5 kg/m2; Class II Obesity: 35–39.9 kg/m2) and grouped by use of etonogestrel implant or nonhormonal contraception for all outcomes. Primary outcome was the proportion of women in each group returning to pregravid weight by 6 months postpartum. Secondary outcomes included waist circumference, motivation to lose weight, eating habits, physical activity, feasibility of study procedures and assessment of recruitment potential in the first 6 months postpartum. Results A total of 127 women enrolled between June 2014 and August 2015. Fifty-seven chose the etonogestrel implant for immediate postpartum contraception while 70 chose nonhormonal contraceptives. Six months after delivery, about half of women in each group returned to within 1.5 kg of pregravid weight (42% etonogestrel [ENG]-implant vs. 67% nonhormonal methods, p=.19). Retention rates were high with over 75% of total study population providing study data at 6 months. Two nonhormonal contraceptive users conceived in the first 4 months postpartum. Conclusion No statistical difference in percentage return to pregravid weight was detected between groups, but data suggest that a somewhat lower proportion of implant users lost weight at 6 months. Rapid recruitment, high retention and marked acceptance of immediate ENG implant use demonstrate feasibility for a larger, adequately powered trial. Implications Immediate postpartum insertion of the ENG implant is safe and effective. Study findings suggest modest interference in overweight and obese women's ability to lose gestational weight. If future research demonstrates no statistical difference, increased uptake in immediate implant use should occur in most women, including those who are overweight or obese.
KW - LARC
KW - Obesity
KW - Postpartum contraception
KW - Weight loss
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U2 - 10.1016/j.contraception.2017.02.020
DO - 10.1016/j.contraception.2017.02.020
M3 - Article
C2 - 28238839
AN - SCOPUS:85014519761
SN - 0010-7824
VL - 95
SP - 564
EP - 570
JO - Contraception
JF - Contraception
IS - 6
ER -
