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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Injectable contraception: what should the longest interval be for reinjections?
Contraception, Volume 77, No. 6, Year 2008
Notification
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Description
Background: Progestin-only injectable contraceptives continue to gain in popularity, but uncertainty remains about pregnancy risk among women late for reinjection. The World Health Organization (WHO) recommends a "grace period" of 2 weeks after the scheduled 13-week reinjection. Beyond 2 weeks, however, many providers send late clients home to await menses. Study design: A prospective cohort study in Uganda, Zimbabwe and Thailand followed users of depot-medroxyprogesterone acetate (DMPA) for up to 24 months. Users were tested for pregnancy at every reinjection, allowing analysis of pregnancy risk among late comers. Results: The analysis consists of 2290 participants contributing 13,608 DMPA intervals. The pregnancy risks per 100 women-years for "on time" [0.6; 95% confidence interval (CI), 0.33-0.92], "2-week grace" (0.0; 95% CI, 0.0-1.88) and "4-week grace" (0.4; 95% CI, 0.01-2.29) injections were low and virtually identical. Conclusion: Extending the current WHO grace period for DMPA reinjection from 2 to 4 weeks does not increase pregnancy risk and could increase contraceptive continuation. © 2008.
Authors & Co-Authors
Steiner, Markus J.
United States, Durham
Fhi 360
Kwok, Cynthia
United States, Durham
Fhi 360
Stanback, John
United States, Durham
Fhi 360
Byamugisha, Josaphat Kayogoza
Uganda, Kampala
Makerere University
Chipato, Tsungai
Zimbabwe, Harare
University of Zimbabwe
Magwali, Thulani Lesley
Zimbabwe, Harare
University of Zimbabwe
Mmiro, Francis A.
Uganda, Kampala
Makerere University
Rugpao, Sungwal
Thailand, Chaing Mai
Chiang Mai University
Sriplienchan, Somchai
United States, Durham
Fhi 360
Morrison, Charles S.
United States, Durham
Fhi 360
Statistics
Citations: 28
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.1016/j.contraception.2008.01.017
ISSN:
00107824
Research Areas
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Uganda
Zimbabwe
Participants Gender
Female