تغییرات وزن 18-12 ماه پس از استفاده از DMPA و IUD: یک مطالعه کوهورت گذشتهنگر

نوع مقاله : اصیل پژوهشی

نویسندگان

1 مربی گروه مامایی، دانشکده علوم پزشکی سیرجان، سیرجان، ایران.

2 استادیار گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تهران، تهران، ایران.

چکیده

مقدمه: IUD و DMPA از روش­های مؤثر تنظیم خانواده هستند که ممکن است استفاده از آنها به‌دلیل وقوع عوارض جانبی ادامه نیابد. مطالعه حاضر با هدف بررسی تغییرات وزن در استفاده‌کنندگان این دو روش انجام شد.
روش‌کار: این مطالعه کوهورت گذشته‌نگر در سال 1396 بر روی 150 زن با IUD و 150 زن با DMPA و با نمونه­گیری تصادفی ساده از 34 مرکز بهداشتی شهر تهران انجام شد. وزن اولیه (W1)، 6 ماه (W2) و سپس 18-12 ماه (W3) پس از مصرف IUD و DMPA ارزیابی گردید. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 20) انجام شد. برای مقایسه اختلاف وزن بین دو مرحله زمانی از آزمون تی مستقل و در سه مرحله زمانی از آزمون اندازه‌گیری تکراری استفاده گردید. میزان p کمتر از 05/0 معنادار در نظر گرفته ‌شد.
یافته‌ها: وزن اولیه در گروه IUD به‌طور معناداری بیشتر از گروه DMPA بود (003/0=p). 6 ماه بعد، افزایش وزن در دو گروه برعکس شده و میانگین اختلاف وزن W2-W1، حاکی از افزایش معنی‌دار وزن در گروه DMPA نسبت به گروه IUD بود (001/0>p). همچنین 18-12 ماه بعد، میانگین اختلاف وزن W3-W1 نشان‌دهنده افزایش معنی‌دار وزن در گروه DMPA نسبت به گروه IUD بود (001/0>p). افزایش وزن در گروه DMPA طی 18-12 ماه در حدود 2 کیلوگرم گزارش شد. بر اساس نتایج آزمون اندازه‌گیری تکراری، تغییرات وزن بین دو گروه در طول زمان معنی‌دار بود (001/0>p). استفاده از DMPA (39/2=B، 0001/0=p) و سزارین (72/0=B، 029/0=p) دو عامل اثرگذار بر افزایش وزن بودند.
نتیجه‌گیری: افزایش وزن، هرچند اندک یکی از عوارض احتمالی استفاده از DMPA است و باید مورد توجه قرار گیرد.

کلیدواژه‌ها


عنوان مقاله [English]

Weight changes 12-18 months after IUD and DMPA usage: A retrospective cohort study

نویسندگان [English]

  • Fatemeh Alavi-Arjas 1
  • Farnaz Farnam 2
1 Instructor, Department of Midwifery, Sirjan School of Medical Sciences, Sirjan, Iran.
2 Assistant Professor, Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Intra Uterine Device (IUD) and Depo-medroxy Progesterone Acetate (DMPA) are effective contraceptive methods that their usage may not be continued due to the occurrence of side effects. This study was performed with aim to evaluate the weight changes in DMPA compared to IUD users.
Method: This retrospective cohort study was performed in 2017 on 150 IUD consumers and 150 DMPA users. Samples were collected from 34 health centers in Tehran by simple random sampling. Baseline weight) W1), 6 months (W2) and then 12 to 18 months (W3) after IUD and DMPA usage was measured. Data were analyzed by SPSS software (version 20). Independent t-test was used to compare the weight difference between the two time stages and repeated measures test was used in three time stages. p < 0.05 was considered statistically significant.
Results: Baseline weight in IUD group was significantly higher than DMPA group (P=0.003). After 6 months, weight gain reversed in two groups and mean difference between W2-W1 showed significant increases in DMPA group in comparison of IUD users (P˂0.001). Also, 12-18 months later, mean difference between W3-W1 indicated significant weight gain in DMPA users than IUD consumers (P˂0.001). Weight gain during 12-18 months in DMPA users was about 2 Kg. Repeated measure analysis showed significant differences between two groups during time (P˂0.001). DMPA usage (P= 0.0001, B=2.39) and Cesarean delivery (P= 0.029, B=0.72) were two significant factors on weight gain.
Conclusion: Weight gain, albeit small is one of the complications of DMPA usage that should be considered.

کلیدواژه‌ها [English]

  • Adverse effects
  • contraceptive
  • Copper Intrauterine Device
  • Depo-Medroxy Progesterone Acetate
  • Weight gain
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