HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) All Versions of this Article: dc07-0180v1 30/8/1952    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Xiang, A. H. Articles by Kjos, S. L. Search for Related Content PubMed PubMed Citation Articles by Xiang, A. H. Articles by Kjos, S. L. Social Bookmarking                What's this?

A LONGITUDINAL STUDY OF LIPIDS AND BLOOD PRESSURE IN RELATION TO METHOD OF CONTRACEPTION IN LATINO WOMEN WITH PRIOR GESTATIONAL DIABETES MELLITUS

Preventive Medicine¹
Medicine²
Obstetrics and Gynecology³ University of Southern California, Los Angeles, CA
⁴Current affiliation: Obstetrics and Gynecology, Harbor UCLA Medical Center, Torrance, CA

xiang{at}usc.edu

ABSTRACT

OBJECTIVE:To investigate effect of non-hormonal contraception (NHC), combination oral contraception (COC), and depo-medroxyprogesterone acetate (DMPA) on lipids and blood pressure in women with recent gestational diabetes mellitus (GDM).

RESEARCH DESIGN:An observational cohort of 972 non-diabetic, normotensive, postpartum Latino women who elected NHC (n=448), COC (n=430) or DMPA (n=94) was followed for at least one subsequent metabolic evaluation on the same contraception. Baseline and follow-up measures included glucose tolerance testing, fasting serum low- (LDL-C) and high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG), systolic (SBP) and diastolic (DBP) blood pressure. Patterns of changes in lipids and BP were evaluated by comparing slopes over follow-up time using random coefficient linear mixed-effect models.

RESULTS:Median follow-up times were 20, 12 and 11 months in NHC, COC and DMPA groups. The DMPA users gained significantly more weight (4.3±6.9 kg/yr) compared to NHC and COC users (1.2±4.7 and 0.7±6.0 kg/yr, p<0.0001). Patterns of change in LDL-C, TG and DBP were not significantly different among groups. HDL-C change differed only between COC and NHC groups (adjusted slopes: 1.0 vs. -1.6 mg/dl/yr, respectively; p<0.0001). SBP change differed only between COC and DMPA groups (adjusted slopes: 1.3 vs. -1.7 mmHg/yr, respectively; p=0.01).

CONCLUSION:These results, derived predominantly from the initial 1-2 years of treatment in Hispanic women, demonstrate that DMPA was associated with greater weight gain than NHC or COCs. Other differences in blood pressure and lipid effects were very small. These findings should be taken into account when advising women with recent GDM about their contraceptive choices.

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?