Pooled incidence of continuation and pregnancy rates of four contraceptive methods in young women: a meta-analysis

Abstract

Background

Continuation rates of contraceptive methods in young women vary among studies, and there is scarce data regarding the pregnancy rate in this population.

Methods

Four independently systematic searches were performed in PUBMED, EMBASE, LILACS, and Cochrane databases from inception until January 2021 for oral contraceptive pill (OCP), copper IUD, levonorgestrel intrauterine system (LNG-IUS), and subdermal implant. Inclusion criteria were observational or RCT studies that reported continuation for at least 12 months and/or pregnancy rate of these contraceptives methods in girls aged 22 years old or younger. Two authors extracted data from the study design and the outcomes. Pooled proportions of each method were applied using the inverse variance in all calculations with LOGIT transformation, using the random-effects model. Cochrane collaboration tool and New Castle-Ottawa were used to assess the quality and bias of all included studies. GRADE criteria evaluated the quality of evidence.

Results

Continuation rate for OCP was 51% (95%CI 34%–68%), while for cooper IUD was 77% (95%CI 74%–80%), LNG-IUS 84% (95%CI 80%–87%), and implant 85% (95%CI 81%–88%). The pooled estimated pregnancy rate for OCP was 11% (95%CI 6%–20%), while for cooper IUD was 5% (95%CI 3%–7%), LNG-IUS 1.6% (95%CI 1.2%–2.3%), and implant 1.8% (95%CI 0.4%–8.4%).

Conclusion

Long-acting contraceptive methods presented higher continuation rates and lower pregnancy rates when compared to OCPs.

摘要

背景：年轻女性持续不同避孕方法的持续应用率在不同的研究中有所不同, 关于该人群妊娠率的数据很少。

方法：从起初至2021年1月, 在PUBMED、EMBASE、LILACS和Cochrane数据库中对口服避孕药(OCP)、宫内节育器、左炔诺孕酮宫内缓释系统(LNG-IUS)和皮下埋植剂进行了四项独立的系统检索。纳入标准为观察性或RCT研究, 这些研究报告了至少持续12个月和/或这些避孕方法在22岁或以下女性中的妊娠率。两位作者从研究设计和结果中提取数据。应用随机效应模型, 在所有计算中应用LOGIT转换的逆方差来应用每种方法的混合比例。Cochrane协作工具和New Castle-Ottawa用于评估所有纳入研究的质量和偏倚。等级标准评价证据的质量。

结果: OCP的持续应用率为51%(95%IC 34%–68%), 宫内节育器为77% (95%IC 74%–80%), LUG-IUS为84%(95%IC 80%–87%), 而皮下植入为85%(95%IC 81%–88%)。OCP的妊娠率为11% (95%IC 6%–20%), 宫内节育器为5% (95%IC 3%–7%), LUG-IUS为1.6% (95%IC 1.2%–2.3%), 皮下植入为1.8% (95%IC 0.4%–8.4%)。

结论:与口服避孕药相比, 长效避孕方法具有较高的持续率和较低的妊娠率。

Keywords:

• Long-Acting reversible contraception
• contraception
• adolescent
• meta-analysis
• epidemiology

Acknowledgement

We thank all collaborators for their support and help in carrying out this study and CAPES for funding this work.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work received an educational grant from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). The funder did not participate in the work.