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
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
Current version onlyImmediate compared to delayed postpartum insertion of contraceptive implants for contraception
Population: postpartum people who desire a contraceptive implant for contraception
| Outcome | Effect | Evidence | Status / 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 participants | Moderate 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 participants | Very 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 participants | Very 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 participants | Low 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 participants | Low 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 participants | Very 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 participants | Low |
Immediate compared to delayed postpartum insertion of IUDs for contraception
Population: postpartum people who desire IUDs for contraception
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of initiation of IUDs Immediate vs delayed postpartum insertion of IUDs | RR 1.27 [1.07, 1.51] | 10 studies · 1894 participants | Moderate Downgraded: inconsistency |
Expulsion by 6 months Immediate vs delayed postpartum insertion of IUDs | RR 4.55 [2.52, 8.19] | 8 studies · 1206 participants | Low |
Utilization rate at 6 months postpartum Immediate vs delayed postpartum insertion of IUDs | RR 1.02 [0.64, 1.62] | 6 studies · 971 participants | Very 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 participants | Very 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 participants | Low |
Any breastfeeding at 6 months (hormonal IUD) Immediate vs delayed postpartum insertion of IUDs | RR 0.9 [0.63, 1.3] | 5 studies · 435 participants | Very low Downgraded: inconsistency |
Immediate postpartum insertion compared with delayed insertion of contraceptive implant for contraception
Population: postpartum women who desire a contraceptive implant for contraception
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of initiation of contraceptive implants Immediate postpartum insertion vs delayed insertion of contraceptive implant | RR 1.41 [1.28, 1.55] | 3 studies · 410 participants | Moderate Downgraded: imprecision |
Continuation rate at 6 months Continuation rate at 12 months Immediate postpartum insertion vs delayed insertion of contraceptive implant | RR 1.02 [0.93, 1.11] | 2 studies · 125 participants | Low Downgraded: imprecision |
Side effects: Abnormal vaginal bleeding within 6 weeks post partum Side effects: Other side effects within 6 weeks Side effects: Heavy, irregular vaginal bleeding or associated severe cramping within 12 months Immediate postpartum insertion vs delayed insertion of contraceptive implant | MD 5.8 [3.79, 7.81] | 1 study · 215 participants | Low Downgraded: imprecision |
Participants' satisfaction at 12 months Immediate postpartum insertion vs delayed insertion of contraceptive implant | no estimate extracted | 1 study · 64 participants | Low Downgraded: risk of bias, imprecision |
Unintended pregnancy rate at 12 months Immediate postpartum insertion vs delayed insertion of contraceptive implant | RR 1.82 [0.38, 8.71] | 1 study · 64 participants | Very low Downgraded: risk of bias, imprecision |
Breastfeeding at six months postpartum Immediate postpartum insertion vs delayed insertion of contraceptive implant | RR 2.01 [0.72, 5.63] | 1 study · 64 participants | Very low Downgraded: risk of bias, imprecision |