Document Detail


The effect of immediate postpartum depot medroxyprogesterone on early breastfeeding cessation.
MedLine Citation:
PMID:  23153897     Owner:  NLM     Status:  MEDLINE    
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:  87     ISSN:  1879-0518     ISO Abbreviation:  Contraception     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-14     Completed Date:  2014-04-07     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  0234361     Medline TA:  Contraception     Country:  United States    
Other Details:
Languages:  eng     Pagination:  836-43     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Breast Feeding*
Cohort Studies
Contraceptive Agents, Female / administration & dosage,  adverse effects*
Delayed-Action Preparations / administration & dosage,  adverse effects
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Medical Records
Medroxyprogesterone Acetate / administration & dosage,  adverse effects*
Models, Biological*
New York
Postpartum Period
Poverty
Proportional Hazards Models
Retrospective Studies
Young Adult
Grant Support
ID/Acronym/Agency:
R01 HD055191/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Contraceptive Agents, Female; 0/Delayed-Action Preparations; C2QI4IOI2G/Medroxyprogesterone Acetate
Comments/Corrections

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