Some effects of depo-medroxyprogesterone acetate (DMPA): observations in the nursing infant and in the long-term user

Abstract

Newborns (210) whose mothers received DMPA postpartum were compared with 121 controls for weight gain and for number of infectious illnesses over an average 1.5 years of follow-up. No differences were found except a possible slight increase in infections when DMPA was started 2 days postpartum. Newborns (118) whose mothers received DMPA prior to conception, 10 newborns exposed to DMPA in utero, and 436 controls showed no significant difference in birth weights or incidence of birth defects. Women (101) receiving DMPA for 8 years or more gained more weight than controls, but showed no cancer or increase in hypertension.

PIP: Several observations are presented regarding the effects of depo-medroxyprogesterone acetate (DMPA) in the human, particularly in the nursing infant exposed to DMPA in breast milk. The observations are based on over 15 years of experience with the use of DMPA at the Maesariang Christian Hospital in Thailand. Records of all infants born at the hospital during 1977, 1978, and 1979 were divided into 4 groups: 1) those whose mothers received DMPA in the first 9 months postpartum; 2) those whose mothers received no DMPA at any time prior to 9 months after the birth of the baby in question; 3) those whose chromosomes had presumably been exposed to DMPA through administration to the mother at some time more than 3 months prior to conception; and 4) those who were inadvertently exposed to DMPA in utero. DMPA was given on a schedule of 150 mg intramuscularly every 3 months. Records of all women who had had at least 32 injections (8 years exposure) were compared with controls matched for age and duration of follow-up. Of the 101 in the DMPA group, 71 were located, interviewed, and examined. The 118 newborns whose mothers received DMPA prior to conception, 10 newborns exposed to DMPA in utero, and 436 controls showed no significant difference in either birth weights or incidence of birth defects. There appeared to be no significant alternation of immunity to infectious disease caused by breast milk containing DMPA. The possible exception to this was the subgroup whose mothers started at 2 days postpartum. This group had about 75% higher incidence of infectious disease visits in the 1st year than the other groups had. The women who received DMPA for 8 years or more gained more weight than controls but showed no cancer or increase in hypertension. The 118 newborns whose mothers had DMPA at some time prior to conception had 2 cases of major anomalies.