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The effect of immediate postpartum depot medroxyprogesterone on early breastfeeding cessation.
MedLine Citation:
PMID:  23153897     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: This study evaluated the effect of immediate postpartum depot medroxyprogesterone (DMPA) on breastfeeding cessation within 6 weeks postpartum. STUDY DESIGN: At low-income-serving obstetric and pediatric clinics, eligible mothers within 1 year postpartum were recruited to participate in a retrospective cohort study. The 183 participants completed a self-administered survey. Surveys were merged with birth certificate data and perinatal maternal/infant medical records. Kaplan-Meier distributions assessed the relationship between DMPA use and breastfeeding cessation. A multivariable Cox proportional hazards model estimated hazard ratios (HRs) and included five known risk factors (age, education, race, parity and parental cohabitation) and identified potential confounders. RESULTS: Consistent with the biologic model, the Kaplan-Meier results raised the possibility of a detrimental effect of DMPA on duration of any breastfeeding, but differences in these distributions did not achieve statistical significance (p=.24); after adjustment for potential confounders, this nonstatistically significant association remained (HR: 1.22; confidence interval: 0.75-1.98). CONCLUSION: Given the state of the evidence, it is unclear whether a causal effect does or does not exist. However, if there is a causal effect of DMPA on breastfeeding duration, it is minimal. Additional well-designed research is warranted.
Authors:
Elizabeth A Brownell; I Diana Fernandez; Susan G Fisher; Cynthia R Howard; Sharon R Ternullo; Ruth A Lawrence; Joseph W Duckett; Ann M Dozier
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-12
Journal Detail:
Title:  Contraception     Volume:  -     ISSN:  1879-0518     ISO Abbreviation:  Contraception     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0234361     Medline TA:  Contraception     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Division of Neonatology, Connecticut Children's Medical Center, Hartford, CT 06106, USA; Division of Research, Connecticut Children's Medical Center, Hartford, CT 06106, USA. Electronic address: EBrownell@CCMCKids.org.
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