OBJECTIVE To evaluate body mass index (BMI) over 36 months among adolescents and young adults using the etonogestrel implant compared with those using depot medroxyprogesterone acetate (DMPA) and a control group. METHODS We conducted a retrospective longitudinal cohort study of postmenarchal adolescents and young adults assigned female at birth. The etonogestrel implant and DMPA groups initiated etonogestrel or DMPA between January 1, 2010, and December 31, 2017. Adolescents and young adults in the control group were prescribed a weight-neutral contraceptive or no contraceptive during the same timeframe. The primary outcome of BMI over time was estimated and compared between study groups with inverse probability of treatment weighting linear mixed-effects modeling. Changes in BMI weight category (underweight or normal weight, overweight, obesity) at 12, 24, and 36 months were also explored. RESULTS Among the 20,409 eligible patients, 860 initiated etonogestrel, 1,817 initiated DMPA, and 17,732 made up the control group. Compared with individuals in the control group, those in the etonogestrel group had a significantly higher mean BMI difference at 9 months (+0.5, P <.01); at 36 months, the mean BMI difference was +1.0 ( P <.01). Compared with individuals in the control group, those in the DMPA group had higher mean BMI at 6 months (+0.3, P <.01); at 36 months, the mean BMI difference was +1.3 ( P <.01). Regardless of weight changes, increases in BMI weight categories were rare in all groups. CONCLUSION Adolescent and young adult patients who initiated the etonogestrel implant demonstrated BMI changes like those on DMPA and higher than control patients; however, these differences may not be clinically concerning. This study provides important information that can help in counseling adolescent and young adult patients about expectations when starting and using etonogestrel.

中文翻译：

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使用依托孕烯皮下埋植剂的青少年和年轻人的体重指数变化。


目的 评估使用依托孕烯植入物的青少年和年轻人与使用长效醋酸甲羟孕酮 （DMPA） 和对照组相比 36 个月内的体重指数 （BMI）。方法 我们对初潮后青少年和出生时被指定为女性的年轻人进行了一项回顾性纵向队列研究。依托孕烯植入物和 DMPA 组在 2010 年 1 月 1 日至 2017 年 12 月 31 日期间启动依托孕烯或 DMPA。对照组中的青少年和年轻人在同一时间范围内服用体重中性避孕药或不使用避孕药。估计 BMI 随时间变化的主要结局，并在研究组之间以治疗加权线性混合效应模型的逆概率进行比较。还探讨了 12 、 24 和 36 个月时 BMI 体重类别 （体重不足或正常体重、超重、肥胖） 的变化。结果 在 20,409 例符合条件的患者中，860 例开始使用依托孕烯，1,817 例开始使用 DMPA，17,732 例为对照组。与对照组个体相比，依托孕烯组患者 9 个月时平均 BMI 差异显著升高 （+0.5，P <.01）;36 个月时，平均 BMI 差异为 +1.0 （P <.01）。与对照组个体相比，DMPA 组大鼠 6 个月时平均 BMI 较高 （+0.3，P <.01）;36 个月时，平均 BMI 差异为 +1.3 （P <.01）。无论体重变化如何，BMI 体重类别的增加在所有组中都很少见。结论 开始依托孕烯植入物的青少年和年轻成人患者表现出与 DMPA 相似且高于对照组患者的 BMI 变化;然而，这些差异在临床上可能并不令人担忧。 本研究提供了重要信息，有助于咨询青少年和年轻成人患者在开始使用依托孕烯时的期望。