Body composition and weight gain in new users of the three-monthly injectable contraceptive, depot-medroxyprogesterone acetate, after 12 months of follow-up

Abstract

Objectives To evaluate weight gain and body composition (BC) in new users of depot-medroxyprogesterone acetate (DMPA) as a contraceptive.Methods This cohort study followed up 20 DMPA users and 20 copper intrauterine device (TCu380A IUD) users, paired for age (± 1 year) and body mass index (BMI ± 1 kg/m2), during 12-months. Healthy, non-obese women aged 18 to 40 years, unaffected by conditions that could influence their body weight, were enrolled. Socio-demographic variables, habits, weight, BMI, BC using dual-energy X-ray absorptiometry, circumferences, skinfold thickness, body fat percentage and waist-to-hip ratio were evaluated. All participants were encouraged to adopt healthy habits.Results At baseline, median age was 29 and 30.5 years, and mean BMI was 24.8 and 24.5 kg/m2 in the DMPA and IUD groups, respectively. At 12 months, an increase was observed in waist and hip circumference in the DMPA users and 8/20 of them had a weight gain ≥ 5% (mean 4.6 kg) with accumulation of fat centrally.Conclusions There were no differences in weight gain or in BC measurements between the groups; nevertheless 40% of women in the DMPA group had larger weight gain and accumulation of fat centrally. The duration of follow-up may have been insufficient to detect differences between the groups.Chinese 摘要 目的 研究应用长效甲羟孕酮避孕对体重和身体成分的影响方法 分别选取20名妇女开始使用长效甲羟孕酮避孕（DMPA组）以及20名开始使用含铜宫内节育器避孕（IUD组）进行队列研究，并按照年龄( ±1 岁)、体重指数（BMI± 1 kg/m2 ）进行配对。40名18-40岁的健康、体重适宜、没有其他可能影响体重因素的妇女入选。记录研究对象的社会人口学特征、生活习惯、体重、体重指数、应用X线骨密度仪测量身体成分、手臂、腰、臀以及大腿的周径、皮肤褶皱的厚度、体脂的百分比以及腰臀比的数据。鼓励所有的研究对象选取健康的生活方式及饮食习惯。结果 入选时两组妇女的平均年龄分别为29岁及30.5岁，体重指数分别为24.8kg/m2以及24.5 kg/m2。12个月后DMPA组的妇女有腰围和臀围的增加，8/20的妇女体重增加≥5%（平均4.6kg）伴有中央性脂肪蓄积的特点。结论 使用DMPA以及使用含铜IUD12个月后的两组妇女在体重增加以及身体成分上的变化没有差异，但是DMPA组有40%的妇女有更多的体重增加以及体脂的中央性蓄积。研究可能需要更长的随访时间来发现两组的差异。