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ENG-releasing subdermal implants in postpartum teenagers - an open-label trial study protocol
M M Barbieri1, C R T Juliato1, L Bahamondes1
1Department of Obstetrics and Gynecology, School of Medical Science, University of Campinas, Av. Alexander Fleming, Campinas, SP, 101, Brazil.
Reproductive Health
|June 25, 2020
Summary
Adolescent pregnancy remains a global concern. This study evaluates the etonogestrel (ENG) implant as a safe, effective postpartum contraceptive option for teenagers, reducing unplanned pregnancies and improving outcomes.
Area of Science:
- Reproductive Health
- Adolescent Medicine
- Contraception
Background:
- Adolescent pregnancy rates are high globally, with Brazil reporting 16% of pregnancies in those under 18.
- Unplanned repeat pregnancies in adolescents contribute to significant public health challenges, including high maternal morbidity and mortality.
- Effective and safe contraceptive methods are crucial for reducing unplanned pregnancies in this demographic.
Purpose of the Study:
- To assess the acceptance and clinical performance of the etonogestrel (ENG)-releasing subdermal contraceptive implant placed postpartum before hospital discharge.
- To compare the ENG implant with other contraceptive methods regarding unplanned pregnancy, continuation, and discontinuation rates among adolescent mothers.
- To evaluate user satisfaction, body composition, and pelvic ultrasound characteristics in adolescents using the ENG implant.
Main Methods:
- A non-randomized open-label trial involving adolescent mothers at the Women's Hospital, University of Campinas, Brazil.
- The study group received the ENG implant before discharge; the comparison group chose other methods at the first postpartum visit.
- Follow-up occurred at 40-60 days, 6 months, and 12 months postpartum, assessing satisfaction, effectiveness, discontinuation, body composition, and pelvic ultrasound.
Main Results:
- The study aims to determine the acceptance rate of the ENG implant among adolescent mothers.
- It will compare the effectiveness and continuation rates of the ENG implant against other postpartum contraceptive methods.
- Clinical performance, including body composition and pelvic ultrasound findings, will be evaluated over one year.
Conclusions:
- Long-acting reversible contraceptives (LARCs), such as subdermal implants, are recommended as first-line contraception for adolescents.
- Immediate postpartum insertion of LARCs is a safe strategy that can significantly decrease rates of repeat unplanned pregnancies.
- This approach helps mitigate the adverse consequences associated with adolescent childbearing.
