Abstract
Assess weight variations in Brazilian users of the 20 microg/day levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena) for comparison with a cohort of users of the TCu 380A intrauterine device (IUD) and a cohort of users of the injectable contraceptive, depot-medroxyprogesterone acetate (DMPA) over a period of five years. A total of 163 users of the LNG-IUS, who had the device inserted in 1998, were admitted to the study. At the time of enrollment, each woman was matched by weight (+/- 1 kg) and age (+/- 1 year) to a woman using a TCu 380A IUD and to another woman using DMPA. All women were followed up for a period of five years. Each year weight was measured and the body mass index (BMI, kg/m2) was calculated. Age of the LNG-IUS users was 27.0 +/- 6.7 years (mean +/- SD), while age of the copper IUD users was 28.0 +/- 6.6 years and that of DMPA users was 26.9 +/- 6.5 years. Weight recorded at the onset of the study was 62.9 +/- 0.8 kg, 62.8 +/- 0.8 kg, and 62.5 +/- 0.9 kg (Mean +/- SD) for users of the LNG-IUS, the copper IUD, and DMPA, respectively. The BMI of women was initially 25.0 (+/- 0.3), 26.4 (+/- 0.3), and 25.5 (+/- 0.4), (Mean +/- SD), for users of the LNG-IUS, copper IUD, and DMPA, respectively. Weight increases of 3.1 kg, 4.9 kg and 8.2 kg were observed at the end of the fifth year among users of the LNG-IUS, copper IUD, and DMPA, respectively (p = 0.009). Increase of the BMI was also observed among all groups (final BMI was 26.3 +/- 0.7, 28.5 +/- 0.8 and 28.7 +/- 1.3 for users of the LNG-IUS, copper IUD and DMPA, respectively). Multivariate analysis showed that there was a significant association between weight increase and length of use of the contraceptive method and of the DMPA. The use of a LNG-IUS during five years caused no significant weight increase and the difference in weight was of the same magnitude as that of copper IUD users.
Highlights
Assess weight variations in Brazilian users of the 20 μg/ day levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena®) for comparison with a cohort of users of the TCu 380A intrauterine device (IUD) and a cohort of users of the injectable contraceptive, depotmedroxyprogesterone acetate (DMPA) over a period of five years
Weight recorded at the onset of the study was 62.9 ± 0.8 kg, 62.8 ± 0.8 kg, and 62.5 ± 0.9 kg (Mean ± SD) for users of the LNG-IUS, the copper IUD, and DMPA, respectively
Weight increases of 3.1 kg, 4.9kg and 8.2kg were observed at the end of the fifth year among users of the LNG-IUS, copper IUD, and DMPA, respectively (p = 0.009)
Summary
O tamanho amostral foi baseado em uma amostra piloto por meio do levantamento aleatório de 12 prontuários de mulheres usuárias de SIU-LNG. A coorte das mulheres usuárias de DIU Tcu foi conseguida por meio de um banco de dados preexistente e já publicado pelo pareamento da idade e do peso com as usuárias de SIU-LNG. Já o IMC no início do estudo foi de 25,0 ± 0,3 kg/m2, 26,4 ± 0,3 kg/m2 e 25,5 ± 0,4 kg/m2 para as usuárias de SIU-LNG, DIU Tcu e AMP-D, respectivamente. Entre as usuárias de DIU Tcu o aumento de peso de 4,9 kg ao longo dos cinco anos, que não foi significativo quando comparado com as usuárias de SIU-LNG (p=0,561). Tabela 1 – Médias do peso e IMC em usuárias de sistema intra-uterino liberador de levonorgestrel (SIU-LNG) e dispositivo intra-uterino de cobre (DIU Tcu) ao longo dos anos. Tabela 3 – Análise de variância multivariada para os métodos SIU-LNG e DIU Tcu em três tempos
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