TY - JOUR
T1 - Does Obesity Influence Body Mass Index Changes in Nulliparous Adolescent Users of Long-Acting Reversible Contraceptives?
AU - Scott, Nadia
AU - Silver, Ellen J.
AU - Dodson, Nancy A.
AU - Coupey, Susan M.
N1 - Funding Information:
The authors would like to thank Shelby Adler, MD, a medical student at the Albert Einstein College of Medicine at the time of data collection, for help reviewing the health records for this study, and Dr. Sofya Maslyanskaya for editing and critical review of the manuscript.
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/12
Y1 - 2021/12
N2 - Objectives: To compare body mass index (BMI) changes in adolescents using long-acting reversible contraceptives (LARCs), specifically, the etonogestrel subdermal implant (ENG-implant), levonorgestrel intrauterine device (LNG-IUD), and copper IUD (Cu-IUD), by initial BMI category from the time of LARC insertion to within 6-18 months after insertion. Design: This was a single-center retrospective cohort study. Setting and Participants: We reviewed electronic health records from our large health system to identify and follow a cohort of 196 adolescents aged 14-19 years with LARCs inserted from 2010 to 2016. We excluded adolescents with conditions or medications affecting weight, including childbirth. Main Outcome Measure: BMI change from LARC insertion to first BMI documented after 6-18 months Results: Mean age was 17.2 ± 0.2 years; 59% of the cohort was Hispanic and 29% Black. Mean BMI was 26.4 ± 7.1 kg/m2. Of the total cohort of adolescents, 51% were underweight/normal, 24% overweight, and 25% obese. Mean time to first BMI documented after LARC insertion was 10.1 ± 3.2 months. Mean BMI change for the total cohort was +0.73 ± 1.8 kg/m2, indicating weight gain. Mean BMI change for the ENG-implant + LNG-IUD users (n = 127) was larger than for Cu-IUD users (n = 69) (+0.92 ± 1.9 kg/m2 vs +0.37 ± 1.6 kg/m2, respectively, P <.05). Two-way analysis of variance showed that both initial BMI category (P =.001) and type of LARC (P =.011) had an independent significant main effect on BMI change. A significant interaction effect (P =.017) showed that obese adolescents had a larger increase in BMI when they were using a progestin-releasing LARC, either ENG-implant or LNG-IUD, as compared to a Cu-IUD (P <.05). Conclusion: Adolescents using progestin-releasing LARCs had a larger increase in BMI within 6-18 months after device insertion than those using Cu-IUDs. The disproportionate increase in BMI with progestin-releasing LARCs was primarily contributed by obese users.
AB - Objectives: To compare body mass index (BMI) changes in adolescents using long-acting reversible contraceptives (LARCs), specifically, the etonogestrel subdermal implant (ENG-implant), levonorgestrel intrauterine device (LNG-IUD), and copper IUD (Cu-IUD), by initial BMI category from the time of LARC insertion to within 6-18 months after insertion. Design: This was a single-center retrospective cohort study. Setting and Participants: We reviewed electronic health records from our large health system to identify and follow a cohort of 196 adolescents aged 14-19 years with LARCs inserted from 2010 to 2016. We excluded adolescents with conditions or medications affecting weight, including childbirth. Main Outcome Measure: BMI change from LARC insertion to first BMI documented after 6-18 months Results: Mean age was 17.2 ± 0.2 years; 59% of the cohort was Hispanic and 29% Black. Mean BMI was 26.4 ± 7.1 kg/m2. Of the total cohort of adolescents, 51% were underweight/normal, 24% overweight, and 25% obese. Mean time to first BMI documented after LARC insertion was 10.1 ± 3.2 months. Mean BMI change for the total cohort was +0.73 ± 1.8 kg/m2, indicating weight gain. Mean BMI change for the ENG-implant + LNG-IUD users (n = 127) was larger than for Cu-IUD users (n = 69) (+0.92 ± 1.9 kg/m2 vs +0.37 ± 1.6 kg/m2, respectively, P <.05). Two-way analysis of variance showed that both initial BMI category (P =.001) and type of LARC (P =.011) had an independent significant main effect on BMI change. A significant interaction effect (P =.017) showed that obese adolescents had a larger increase in BMI when they were using a progestin-releasing LARC, either ENG-implant or LNG-IUD, as compared to a Cu-IUD (P <.05). Conclusion: Adolescents using progestin-releasing LARCs had a larger increase in BMI within 6-18 months after device insertion than those using Cu-IUDs. The disproportionate increase in BMI with progestin-releasing LARCs was primarily contributed by obese users.
KW - Adolescents
KW - Body mass index
KW - Long-acting reversible contraception
KW - Obesity
KW - Progestins
UR - http://www.scopus.com/inward/record.url?scp=85115007841&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85115007841&partnerID=8YFLogxK
U2 - 10.1016/j.jpag.2021.08.004
DO - 10.1016/j.jpag.2021.08.004
M3 - Article
C2 - 34389461
AN - SCOPUS:85115007841
SN - 1083-3188
VL - 34
SP - 815
EP - 820
JO - Journal of Pediatric and Adolescent Gynecology
JF - Journal of Pediatric and Adolescent Gynecology
IS - 6
ER -
