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Effectiveness of long-acting reversible contraception
Brooke Winner1, Jeffrey F Peipert, Qiuhong Zhao
1Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO 63110, USA.
The New England Journal of Medicine
|May 25, 2012
Summary
Long-acting reversible contraception is highly effective in preventing unintended pregnancies, outperforming pills, patches, and rings. This superior effectiveness holds true for adolescents and young women, offering a reliable contraceptive option.
Area of Science:
- Reproductive Health
- Contraception Effectiveness
- Public Health
Background:
- Unintended pregnancy rates in the U.S. are high compared to other developed countries.
- Contraceptive failure, often due to inconsistent or incorrect use, accounts for half of unintended pregnancies.
- There is a need for more effective methods to reduce unintended pregnancies.
Purpose of the Study:
- To evaluate the effectiveness of long-acting reversible contraception (LARC) compared to other methods.
- To assess LARC effectiveness in reducing unintended pregnancies.
- To compare failure rates across different contraceptive methods and age groups.
Main Methods:
- A prospective cohort study involving 7486 participants.
- Comparison of LARC (IUDs, implants) failure rates against oral contraceptive pills, transdermal patch, vaginal ring, and depot medroxyprogesterone acetate (DMPA) injection.
- Stratification of participants by age (under 21 vs. 21 and older).
Main Results:
- LARC failure rate was 0.27 per 100 participant-years, significantly lower than 4.55 for pills, patch, or ring.
- The hazard ratio for unintended pregnancy with LARC vs. other methods was 21.8.
- Younger participants (<21) using pills, patch, or ring had nearly double the risk of unintended pregnancy compared to older participants.
Conclusions:
- Long-acting reversible contraception demonstrates superior effectiveness over pills, patch, and ring.
- LARC effectiveness is consistent across all age groups, including adolescents and young women.
- LARC offers a reliable strategy to decrease unintended pregnancies.
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