Effect of early postpartum use of the contraceptive implants, NORPLANT®, on the serum levels of immunoglobulins of the mothers and their breastfed infants

Abdulla, Kamal A.; Elwan, Sawsan I.; Salem, Heba; Shaaban, Mamdouh M.

doi:10.1016/0010-7824(85)90049-6

Cited by 19 publications

(3 citation statements)

References 9 publications

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“…In one study, infant weight was no different between norethindrone implant and barrier method users [49]. Another found no health or serum immunoglobulin differences between infants of LNG implant and nonhormonal users [66] and another found no differences in mean FSH, LH or testosterone [65]. One study found slower weight gain in infants of LNG implant users up to 3 months, compared with Cu-IUD users.…”

Section: Rctsmentioning

confidence: 99%

Progestogen-only contraceptive use among breastfeeding women: a systematic review

2010

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Background: Postpartum women need effective contraception. Concerns have been raised that use of progestogen-only contraceptives (POCs) may affect breastfeeding performance and infant health outcomes. Objectives: We investigated the clinical outcomes of breastfeeding duration, initiation of supplemental feeding and weaning, as well as infant outcomes including infant growth, health and development among breastfeeding women using POCs compared with breastfeeding women not using POCs. Search strategy: We searched the PubMed database for all articles published from database inception through December 2014. Selection criteria: We included primary research studies of breastfeeding women of any age or parity who received POCs, including progestogen-only pills, injectables, implants or hormonal intrauterine devices (IUDs). The main outcomes were breastfeeding performance (as measured by initiation, continuation, frequency and exclusivity of breastfeeding) and infant health (as measured by growth, development or adverse health effects). Results: Forty-nine articles reporting on 47 different studies were identified that investigated the use of POCs in breastfeeding women and reported clinically relevant outcomes of infant growth, health or breastfeeding performance. Studies ranged from poor to fair methodological quality and generally failed to show negative effects of the use of POCs on breastfeeding outcomes or on infant growth or development. One randomized controlled trial (RCT) raises concerns that immediate insertion of the levonorgestrel IUD postpartum may be associated with poorer breastfeeding performance when compared with delayed insertion, although two other RCTs evaluating early etonogestrel implants compared with delayed initiation of implants or depot medroxyprogesterone acetate failed to find such an association. Conclusion: The preponderance of evidence fails to demonstrate adverse breastfeeding outcomes or negative health outcomes in infants such as restricted growth, health problems or impaired development. Evidence newly added to this review was largely consistent with previous evidence.

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Section: Rctsmentioning

confidence: 99%

Progestogen-only contraceptive use among breastfeeding women: a systematic review

2010

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“…An important advantage of sustained-release, low-dose progestin contraception is their minimal metabolic effects. Studies of progestin implants have not detected changes outside of the normal range in carbohydrate metabolism, [61][62][63][64] liver function, [64][65][66][67][68] thyroid function, [69][70][71][72] adrenal function, 69,71,73,74 coagulation, 67,68,75,76 levels of immunoglobulins, 61,77 or blood chemistries. 61,66 Initial studies suggested a mild, although not clinically significant, decrease in insulin sensitivity in nondiabetic women.…”

Section: Minimal Metabolic Effectmentioning

confidence: 99%

Implant Contraception

Meckstroth¹,

Darney²

2001

Semin Reprod Med

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The experience of 6 million Norplant users has led to several more advanced implants. Implanon is a single-rod implant system containing a low androgenic progestin and requires 1 to 2 minutes for insertion and removal. Like other implants, Implanon prevents pregnancy by changing the character of the cervical mucus and interfering with luteal function. Unlike Norplant, though, Implanon is designed to prevent ovulation for the full duration of use. Implant contraception has several advantages over other types of contraception including high efficacy, minimal required maintenance, absence of estrogen, and rapid return of fertility after discontinuation. Implants can be a good choice for adolescents; women with hypertension, diabetes, anemia, endometriosis, or other medical problems; and women who are breast-feeding. Irregular bleeding is the most common adverse effect of implants and can be treated with several medication regimens. Preinsertion counseling, however, is the most important factor in ensuring satisfaction with implants. Unfortunately, no implant system is currently available in the United States since August 2000, but Implanon is expected to reach the U.S. market within the next 2 years.

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“…For women using levonorgestrel-releasing IUDs, compared to non-hormonal IUDs, no differences were noted in infants’ serum electrolytes, protein, creatinine, iron, cholesterol, or liver enzyme levels [31]. Similarly, no differences in the biochemical markers of FSH, LH, testosterone, or immunoglobin differences were noted between male infants of progestin-only pill users or users of a progestin-implant compared to non-hormonal contraceptive users [34, 35]. …”

Section: Introductionmentioning

confidence: 99%

Optimizing maternal and neonatal outcomes with postpartum contraception: impact on breastfeeding and birth spacing

Sridhar

Salcedo

2017

matern health, neonatol and perinatol

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Postpartum contraception is important to prevent unintended pregnancies. Assisting women in achieving recommended inter-pregnancy intervals is a significant maternal-child health concern. Short inter-pregnancy intervals are associated with negative perinatal, neonatal, infant, and maternal health outcomes. More than 30% of women experience inter-pregnancy intervals of less than 18 months in the United States. Provision of any contraceptive method after giving birth is associated with improved inter-pregnancy intervals. However, concerns about the impact of hormonal contraceptives on breastfeeding and infant health have limited recommendations for such methods and have led to discrepant recommendations by organizations such as the World Health Organization and the U.S. Centers for Disease Control and Prevention. In this review, we discuss current recommendations for the use of hormonal contraception in the postpartum period. We also discuss details of the lactational amenorrhea method and effects of hormonal contraception on breastfeeding. Given the paucity of high quality evidence on the impact on hormonal contraception on breastfeeding outcomes, and the strong evidence for improved health outcomes with achievement of recommended birth spacing intervals, the real risk of unintended pregnancy and its consequences must not be neglected for fear of theoretical neonatal risks. Women should establish desired hormonal contraception before the risk of pregnancy resumes. With optimization of postpartum contraception provision, we will step closer toward a healthcare system with fewer unintended pregnancies and improved birth outcomes.

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Effect of early postpartum use of the contraceptive implants, NORPLANT®, on the serum levels of immunoglobulins of the mothers and their breastfed infants

Cited by 19 publications

References 9 publications

Progestogen-only contraceptive use among breastfeeding women: a systematic review

Progestogen-only contraceptive use among breastfeeding women: a systematic review

Implant Contraception

Optimizing maternal and neonatal outcomes with postpartum contraception: impact on breastfeeding and birth spacing

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