Twelve-month discontinuation of etonogestrel implant in an outpatient pediatric setting

The etonogestrel (ENG) contraceptive implant is the most effective reversible contraceptive method. Uptake remains limited in adolescents, a population at high risk for unintended pregnancy. The objectives of this study were to determine the 12-month discontinuation rate of the ENG implant among ado...

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Bibliographic Details
Published in:Contraception (Stoneham) 2016-07, Vol.94 (1), p.81-86
Main Authors: Berlan, Elise, Mizraji, Kelly, Bonny, Andrea E.
Format: Article
Language:English
Subjects:
Adolescent
Adolescents
Child
Contraception
Contraception - utilization
Contraceptive Agents, Female - administration & dosage
Contraceptive Agents, Female - therapeutic use
Desogestrel - administration & dosage
Desogestrel - therapeutic use
Device Removal - statistics & numerical data
Etonogestrel
Female
Hemorrhage - etiology
Humans
Implant
Logistic Models
Multivariate Analysis
Outpatients
Pediatric
Pediatrician
Pregnancy
Pregnancy in Adolescence - prevention & control
Retrospective Studies
Time Factors
United States
Young Adult
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Summary:The etonogestrel (ENG) contraceptive implant is the most effective reversible contraceptive method. Uptake remains limited in adolescents, a population at high risk for unintended pregnancy. The objectives of this study were to determine the 12-month discontinuation rate of the ENG implant among adolescents in an outpatient setting and to characterize risk factors for discontinuation. A retrospective chart review identified adolescent females aged 12 to 22years who received the ENG implant in one pediatric institution between January 1, 2011, and April 15, 2014. Patients were categorized into ENG discontinuers (removed prior to 12months) and ENG continuers (continued for ≥12months). Associations between demographic, clinical and postplacement characteristics with ENG discontinuation category were assessed with t tests, χ2/Fisher's Exact Tests and backwards stepwise logistic regression. Of the 750 patients who had an ENG implant inserted, 77 (10.3%) had the device removed prior to 12months of use. The mean length of implant use for those who discontinued was 7.5months. Problematic bleeding was the most commonly cited reason for discontinuation. Older age at time of insertion, history of pregnancy and ≥1 medical visit for implant concerns (not including removal) were independently predictive (p
ISSN:0010-7824
1879-0518
DOI:10.1016/j.contraception.2016.02.030