Effect of body weight and BMI on the efficacy of levonorgestrel emergency contraception
| Autor: | Nathalie Kapp, Bruno Scherrer, André Ulmann, Erin Gainer, Henri Camille Mathe, Hélène Guillard, Jean Louis Abitbol |
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| Rok vydání: | 2015 |
| Předmět: |
Risk
medicine.medical_specialty Pregnancy Rate medicine.medical_treatment Population Drug Resistance Levonorgestrel Models Biological Drug Administration Schedule Body Mass Index law.invention Randomized controlled trial Pregnancy law medicine Humans Emergency contraception education Contraceptives Postcoital education.field_of_study business.industry Obstetrics Body Weight Obstetrics and Gynecology Overweight medicine.disease Pregnancy Unwanted United Kingdom United States Reproductive Medicine Hormonal contraception Family planning Female business Ireland Body mass index Follow-Up Studies medicine.drug |
| Zdroj: | Contraception. 91:97-104 |
| ISSN: | 0010-7824 |
| DOI: | 10.1016/j.contraception.2014.11.001 |
| Popis: | To further evaluate the effect of weight and body mass index (BMI) on the efficacy of levonorgestrel emergency contraception.Data from two large, multicenter, randomized controlled trials designed to assess emergency contraceptive efficacy were pooled to evaluate the effect of weight and BMI on pregnancy rates among women who received levonorgestrel. Descriptive methods (comparison of means and distributions according to pregnancy status and pregnancy rates across weight and BMI categories) as well as cubic spline modeling were used to describe the relationship between pregnancy risk and weight/BMI.The analysis population comprised 1731 women, among whom 38 pregnancies were reported. Women for whom levonorgestrel was not effective in preventing pregnancy had a significantly higher mean body weight and BMI than women who did not become pregnant (76.7 vs. 66.4 kg, p.0001; 28.1 vs. 24.6 kg/m², p.0001). The estimated pregnancy rate increased significantly from 1.4% [95% confidence interval (CI): 0.5%-3.0%] among the group of women weighing 65-75 kg to 6.4% (95% CI: 3.1%-11.5%) and 5.7% (95% CI: 2.9%-10.0%) in the 75-85 kg and85 kg groups, respectively. Statistical modeling demonstrated a steep increase in pregnancy risk starting from a weight near 70-75 kg to reach a risk of pregnancy of 6% or greater around 80 kg. Similar results were obtained for statistical modeling of BMI as well as when the two studies were analyzed individually.All analyses showed a significant drop in the efficacy of levonorgestrel emergency contraception with increasing body weight, with pregnancy risk in the higher weight categories similar to expected rates in the absence of contraception. Like body weight, increasing BMI was highly correlated with increased pregnancy risk. |
| Databáze: | OpenAIRE |
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