Document Detail


Injectable contraception: what should the longest interval be for reinjections?
MedLine Citation:
PMID:  18477489     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Progestin-only injectable contraceptives continue to gain in popularity, but uncertainty remains about pregnancy risk among women late for reinjection. The World Health Organization (WHO) recommends a "grace period" of 2 weeks after the scheduled 13-week reinjection. Beyond 2 weeks, however, many providers send late clients home to await menses. STUDY DESIGN: A prospective cohort study in Uganda, Zimbabwe and Thailand followed users of depot-medroxyprogesterone acetate (DMPA) for up to 24 months. Users were tested for pregnancy at every reinjection, allowing analysis of pregnancy risk among late comers. RESULTS: The analysis consists of 2290 participants contributing 13,608 DMPA intervals. The pregnancy risks per 100 women-years for "on time" [0.6; 95% confidence interval (CI), 0.33-0.92], "2-week grace" (0.0; 95% CI, 0.0-1.88) and "4-week grace" (0.4; 95% CI, 0.01-2.29) injections were low and virtually identical. CONCLUSION: Extending the current WHO grace period for DMPA reinjection from 2 to 4 weeks does not increase pregnancy risk and could increase contraceptive continuation.
Authors:
Markus J Steiner; Cynthia Kwok; John Stanback; Josaphat K Byamugisha; Tsungai Chipato; Thulani Magwali; Francis Mmiro; Sungwal Rugpao; Somchai Sriplienchan; Charles Morrison
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2008-04-10
Journal Detail:
Title:  Contraception     Volume:  77     ISSN:  0010-7824     ISO Abbreviation:  Contraception     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-14     Completed Date:  2008-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0234361     Medline TA:  Contraception     Country:  United States    
Other Details:
Languages:  eng     Pagination:  410-4     Citation Subset:  IM    
Affiliation:
Family Health International, Research Triangle Park, NC 27709, USA. msteiner@fhi.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Cohort Studies
Contraception Behavior
Contraceptive Agents, Female / administration & dosage*
Drug Administration Schedule
Female
Humans
Injections, Intramuscular
Medroxyprogesterone / administration & dosage*
Pregnancy
Pregnancy Rate*
Prospective Studies
Thailand
Treatment Outcome
Uganda
Zimbabwe
Grant Support
ID/Acronym/Agency:
N01-HD-0-3310/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Contraceptive Agents, Female; 520-85-4/Medroxyprogesterone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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