Early weight gain predicting later weight gain among depot medroxyprogesterone acetate users.

Abstract

OBJECTIVE:

To examine if early weight gain in depot medroxyprogesterone acetate (DMPA) users predicts continued excessive weight gain and to identify risk factors of early weight gain in DMPA users.

METHODS:

Depot medroxyprogesterone acetate users (N=240) were assessed before initiating contraception and every 3 months for 36 months. Early weight gain was defined as more than 5% baseline weight gain within 6 months of DMPA use. Mean weight gain at 6-month intervals was estimated based on early weight gain status (at or below 5% gain compared with above 5% gain). Multiple logistic and mixed-model regression analyses were used.

RESULTS:

About one-fourth of DMPA users had early weight gain. The mean weight gain of the at or below 5% group and above 5% group was 0.63 kg and 8.04 kg, 1.48 kg and 10.86 kg, and 2.49 kg and 11.08 kg after 12, 24, and 36 months (P<.001 at all observations), respectively. Early weight gainers also had a much steeper slope of weight gain over time than the regular weight gainers (0.35 kg/month compared with 0.08 kg/month, P<.001). Risk factors for early weight gain were body mass index less than 30 (odds ratio [OR] 4.00, 95% confidence interval [CI] 1.513-10.455), parity (OR 2.23, 95% CI:1.040-4.761), and self-reported increased appetite after 6 months of DMPA use (OR 3.06, 95% CI 1.505-6.214).

CONCLUSION:

Most DMPA users who gain excessive weight experience more than a 5% weight increase within 6 months. These data help physicians predict who is at risk of excessive gain and counsel them appropriately.

LEVEL OF EVIDENCE:

II.

• Authors: Yen-Chi L Le, Mahbubur Rahman, Abbey B Berenson
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 114 Issue 2 Pt 1 Pg. 279-284 (Aug 2009) ISSN: 0029-7844 [Print] United States
• PMID: 19622988 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Contraceptive Agents, Female
• Delayed-Action Preparations
• Medroxyprogesterone Acetate

Topics

• Adolescent
• Adult
• Appetite
• Body Mass Index
• Contraceptive Agents, Female (administration & dosage, adverse effects)
• Delayed-Action Preparations
• Female
• Humans
• Medroxyprogesterone Acetate (administration & dosage, adverse effects)
• Parity
• Pregnancy
• Regression Analysis
• Weight Gain (drug effects)