Cochrane · systematic review · CD011913

Immediate versus delayed postpartum insertion of contraceptive implant and IUD for contraception

Sothornwit, J, Kaewrudee, S, Lumbiganon, P, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library

Fertility Regulation2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
13
current version
GRADE rated
13
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 6 · 46.2%Low 5 · 38.5%Moderate 2 · 15.4%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Immediate compared to delayed postpartum insertion of contraceptive implants for contraception

Population: postpartum people who desire a contraceptive implant for contraception
7 questions
OutcomeEffectEvidenceStatus / GRADE
Rate of initiation of contraceptive implants
Immediate vs delayed postpartum insertion of contraceptive implants
RR 1.48 [1.11, 1.98]5 studies · 715 participantsModerate
Downgraded: inconsistency
Utilization rate at 6 months postpartum
Immediate vs delayed postpartum insertion of contraceptive implants
RR 1.16 [0.9, 1.5]3 studies · 330 participantsVery low
Downgraded: inconsistency
Utilization rate at 12 months postpartum
Immediate vs delayed postpartum insertion of contraceptive implants
RR 0.98 [0.93, 1.04]2 studies · 164 participantsVery low
Adverse effect: mean days of prolonged vaginal bleeding within 6 weeks postpartum
Immediate vs delayed postpartum insertion of contraceptive implants
MD 2.98 [2.71, 8.66]2 studies · 420 participantsLow
Downgraded: inconsistency
Adverse effects other than prolonged vaginal bleeding
Immediate vs delayed postpartum insertion of contraceptive implants
RR 2.06 [1.38, 3.06]1 study · 215 participantsLow
Downgraded: risk of bias, imprecision, inconsistency
Unintended pregnancy rate at 12 months postpartum
Immediate vs delayed postpartum insertion of contraceptive implants
RR 1.82 [0.38, 8.71]1 study · 64 participantsVery low
Any breastfeeding at six months postpartum
Immediate vs delayed postpartum insertion of contraceptive implants
RR 0.97 [0.92, 1.01]2 studies · 225 participantsLow

Immediate compared to delayed postpartum insertion of IUDs for contraception

Population: postpartum people who desire IUDs for contraception
6 questions
OutcomeEffectEvidenceStatus / GRADE
Rate of initiation of IUDs
Immediate vs delayed postpartum insertion of IUDs
RR 1.27 [1.07, 1.51]10 studies · 1894 participantsModerate
Downgraded: inconsistency
Expulsion by 6 months
Immediate vs delayed postpartum insertion of IUDs
RR 4.55 [2.52, 8.19]8 studies · 1206 participantsLow
Utilization rate at 6 months postpartum
Immediate vs delayed postpartum insertion of IUDs
RR 1.02 [0.64, 1.62]6 studies · 971 participantsVery low
Downgraded: inconsistency
Utilization rate at 12 months postpartum
Immediate vs delayed postpartum insertion of IUDs
RR 0.86 [0.5, 1.49]3 studies · 796 participantsVery low
Downgraded: inconsistency
Unintended pregnancy at 12 months postpartum
Immediate vs delayed postpartum insertion of IUDs
RR 0.26 [0.17, 0.41]1 study · 1000 participantsLow
Any breastfeeding at 6 months (hormonal IUD)
Immediate vs delayed postpartum insertion of IUDs
RR 0.9 [0.63, 1.3]5 studies · 435 participantsVery low
Downgraded: inconsistency