Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, (LUTH), Lagos, Nigeria.
Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Nigeria.
Afr J Reprod Health. 2020 Jun;24(2):48-63. doi: 10.29063/ajrh2020/v24i2.5.
Uptake and continuation of long acting reversible contraceptives (LARC) such as subdermal levonorgestrel implants are pivotal to the achievement of some sustainable development goals (SDG). We evaluated Jadelle uptake and factors affecting its discontinuation in the first three years of initiation at the Family Planning Clinic of the College of Medicine, University of Lagos (CMUL), Nigeria. A retrospective cohort study was conducted among 517 consecutive new Jadelle acceptors, at the family planning clinic of CMUL, between 1 October 2007 and 30 September 2010, who were followed up till 30 September 2011. Survival life table analysis, Kaplan-Meier plots and multivariable Cox proportional hazard regression were conducted to evaluate factors affecting time to Jadelle discontinuation. Stata version 13 statistical software (StataCorp USA) was used for analysis. The mean age of Jadelle acceptors was 32.9 (S.D: ±5.4) years and uptake rate of Jadelle was 61.8%. The overall discontinuation rate was 19 per 100 women-years while the 1-year, 2-year and 3-year Jadelle discontinuation rates were 7.1%; 27.0% and 58.1% respectively. Increased age, (P=0.047) and previous contraceptive use (P <0.001) were independent predictors of Jadelle discontinuation. Menstrual irregularity (51.4%) and intention to get pregnant (40.3%) were the commonest reasons for discontinuation. The failure rate was low at 0.27 per 100 women-years. This study showed that Jadelle had a high uptake rate complimented by a low failure rate; and is quite suitable for postpartum childbirth spacing as well as ongoing long term contraception.
皮下埋植左炔诺孕酮作为长效可逆避孕方法（LARC）之一，其使用率和续用率对实现某些可持续发展目标（SDG）至关重要。我们评估了尼日利亚拉各斯大学医学院计划生育诊所（CMUL）皮下埋植左炔诺孕酮的使用情况和影响其停用的因素，该研究为回顾性队列研究，纳入了 2007 年 10 月 1 日至 2010 年 9 月 30 日期间在 CMUL 计划生育诊所新使用皮下埋植左炔诺孕酮的 517 名连续患者，随访至 2011 年 9 月 30 日。使用生存生命表分析、Kaplan-Meier 图和多变量 Cox 比例风险回归评估影响皮下埋植左炔诺孕酮停用时间的因素。使用 Stata 版本 13 统计软件（StataCorp USA）进行分析。皮下埋植左炔诺孕酮使用者的平均年龄为 32.9（S.D：±5.4）岁，使用率为 61.8%。总的停药率为每 100 名妇女年 19 例，1 年、2 年和 3 年的停药率分别为 7.1%、27.0%和 58.1%。年龄增加（P=0.047）和既往使用过避孕方法（P<0.001）是皮下埋植左炔诺孕酮停药的独立预测因素。不规则出血（51.4%）和计划怀孕（40.3%）是停药的最常见原因。失败率为每 100 名妇女年 0.27 例。本研究表明，皮下埋植左炔诺孕酮的使用率高，失败率低，非常适合产后生育间隔和长期持续避孕。
