Abstract
ObjectiveTo compare 2-year continuation rates in Malawian women undergoing immediate postpartum insertion of the levonorgestrel implant or etonorgestrel implant. Study designWe followed 159 women who underwent immediate postpartum levonorgestrel implant or etonorgestrel implant insertion at Kasungu District Hospital for up to 2 years. ResultsWe analyzed continuation data on 145 (92.4%) implant users. The 2-year continuation rates were 93.4 (95% CI 86.5–96.8) for levonorgestrel implant and 96.3 (95% CI: 76.5–99.5) for etonorgestrel implant (p=.268). ConclusionsImmediate postpartum implant insertion of both the levonorgestrel and etonorgestrel implant had high continuation rates at 2 years in Malawian women. ImplicationsImmediate postpartum implant insertion of both the levonorgestrel and etonorgestrel implant had continuation rates of over 90% at 2 years among our population of Malawian women. Both implants should be offered routinely to eligible and interested women prior to hospital discharge after delivery.
Highlights
Malawi has high rates of maternal mortality and unintended pregnancy [1]
We calculated 2-year continuation rates of 93.4 for the levonorgestrel implant and 96.3 for the etonorgestrel implant (p=.625)
In a sensitivity analysis in which participants were considered discontinuers when lost-to-follow-up, we found 2-year continuation rates of 78.4 for the levonorgestrel implant and 82.1 for the etonorgestrel implant (p=.703)
Summary
Malawi has high rates of maternal mortality and unintended pregnancy [1]. Increased access to immediate postpartum long-acting reversible contraception (LARC) could decrease both. Many countries across sub-Saharan Africa (SSA) have implemented immediate postpartum intrauterine device (IUD) insertion [2,3,4,5,6], few have implemented immediate postpartum implant insertion because it was considered to be WHO Medical Eligibility Criteria 3 (a condition where the theoretical or proven risks usually outweigh the advantages of using the method) until 2015 [7,8]. Of the two published studies that evaluated immediate postpartum implant in SSA, neither followed women for more than 6 months after delivery [9,10]. Our study objective was to compare 2-year continuation rates among women who received either the 5year levonorgestrel implant or the 3-year etonorgestrel implant immediately postpartum at a district hospital in Malawi
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
