Early weight gain related to later weight gain in adolescents on depot medroxyprogesterone acetate.

OBJECTIVE

To examine whether early weight gain in adolescents on depot medroxyprogesterone acetate (DMPA) predicts continued excessive weight gain and identify risk factors of early weight gain.

METHODS

Adolescents (n=97) initiating DMPA were eligible to participate. Height and weight were assessed at baseline and at 6, 12, and 18 months. Early weight gain was defined as more than a 5% weight gain after 6 months of DMPA use. Mean body mass index (BMI) at 6-month intervals was estimated based on early weight-gain status (5% or less gain compared with greater than 5% gain). Analysis of variance modeling was used to compare group BMI at each time point. Repeated-measures analysis of covariance modeling was used to explore the association between early weight gain and percentage change in BMI at 12 and 18 months of DMPA use.

RESULTS

Twenty patients (21%) had early weight gain. Mean BMI for the 5% or less group and greater than 5% group was 23.4 and 24.5 (P=.31), 23.3 and 26.6 (P=.009), 24.2 and 28.7 (P=.007), and 25.7 and 32.1 (P=.01) at 0, 6, 12, and 18 months, respectively. Early weight gain was significantly associated with percentage change in BMI at 12 and 18 months (P<.001). No risk factors for early weight gain were identified.

CONCLUSION

Adolescents who experience more than 5% weight gain after 6 months of DMPA use are at risk for continued excessive weight gain. Weight gain after 6 months on DMPA can be used to identify adolescents at risk for continued weight gain, and appropriate counseling can be done at this time point.

LEVEL OF EVIDENCE

II.