Does Obesity Influence Body Mass Index Changes in Nulliparous Adolescent Users of Long-Acting Reversible Contraceptives?

Nadia Scott, Ellen J. Silver, Nancy A. Dodson, Susan M. Coupey

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To compare body mass index (BMI) changes in adolescents using long-acting reversible contraceptives (LARCs), specifically, the etonogestrel subdermal implant (ENG-implant), levonorgestrel intrauterine device (LNG-IUD), and copper IUD (Cu-IUD), by initial BMI category from the time of LARC insertion to within 6-18 months after insertion. Design: This was a single-center retrospective cohort study. Setting and Participants: We reviewed electronic health records from our large health system to identify and follow a cohort of 196 adolescents aged 14-19 years with LARCs inserted from 2010 to 2016. We excluded adolescents with conditions or medications affecting weight, including childbirth. Main Outcome Measure: BMI change from LARC insertion to first BMI documented after 6-18 months Results: Mean age was 17.2 ± 0.2 years; 59% of the cohort was Hispanic and 29% Black. Mean BMI was 26.4 ± 7.1 kg/m2. Of the total cohort of adolescents, 51% were underweight/normal, 24% overweight, and 25% obese. Mean time to first BMI documented after LARC insertion was 10.1 ± 3.2 months. Mean BMI change for the total cohort was +0.73 ± 1.8 kg/m2, indicating weight gain. Mean BMI change for the ENG-implant + LNG-IUD users (n = 127) was larger than for Cu-IUD users (n = 69) (+0.92 ± 1.9 kg/m2 vs +0.37 ± 1.6 kg/m2, respectively, P <.05). Two-way analysis of variance showed that both initial BMI category (P =.001) and type of LARC (P =.011) had an independent significant main effect on BMI change. A significant interaction effect (P =.017) showed that obese adolescents had a larger increase in BMI when they were using a progestin-releasing LARC, either ENG-implant or LNG-IUD, as compared to a Cu-IUD (P <.05). Conclusion: Adolescents using progestin-releasing LARCs had a larger increase in BMI within 6-18 months after device insertion than those using Cu-IUDs. The disproportionate increase in BMI with progestin-releasing LARCs was primarily contributed by obese users.

Original languageEnglish (US)
Pages (from-to)815-820
Number of pages6
JournalJournal of Pediatric and Adolescent Gynecology
Volume34
Issue number6
DOIs
StatePublished - Dec 2021
Externally publishedYes

Keywords

  • Adolescents
  • Body mass index
  • Long-acting reversible contraception
  • Obesity
  • Progestins

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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