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Does progestin-only contraceptive use after pregnancy affect recovery from pelvic girdle pain?: A prospective population study
Akershus Univ Hosp, Hlth Serv Res Unit, Lorenskog, Norway.;Norwegian Inst Publ Hlth, Dept Hlth & Aging, Oslo, Norway.;Akershus Univ Hosp, Dept Obstet & Gynecol, Lorenskog, Norway..
Natl Hosp Norway, Oslo Univ Hosp, Norwegian Natl Advisory Unit Womens Hlth, Oslo, Norway.;Norwegian Inst Publ Hlth, Dept Child Hlth, Oslo, Norway..
Norwegian Inst Publ Hlth, Dept Child Hlth, Oslo, Norway.;Univ Oslo, Sch Pharm, PharmacoEpidemiol & Drug Safety Res Grp, Oslo, Norway..
Norwegian Inst Publ Hlth, Dept Hlth & Aging, Oslo, Norway..
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2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 9, article id e0184071Article in journal (Refereed) Published
Abstract [en]

Objective: To estimate associations of progestin-only contraceptives with persistent pelvic girdle pain 18 months after delivery.

Methods: Prospective population based cohort study during the years 2003-2011. We included 20,493 women enrolled in the Norwegian Mother and Child Cohort Study who reported pelvic girdle pain in pregnancy week 30. Data were obtained by 3 self-administered questionnaires and the exposure was obtained by linkage to the Prescription Database of Norway. The outcome was pelvic girdle pain 18 months after delivery.

Results: Pelvic girdle pain 18 months after delivery was reported by 9.7% (957/9830) of women with dispense of a progestin-only contraceptive and by 10.5% (1114/10,663) of women without dispense (adjusted odds ratio 0.93; 95% CI 0.84-1.02). In sub-analyses, long duration of exposure to a progestin intrauterine device or progestin-only oral contraceptives was associated with reduced odds of persistent pelvic girdle pain (P-trend = 0.021 and P-trend = 0.005). Conversely, long duration of exposure to progestin injections and/or a progestin implant was associated with modest increased odds of persistent pelvic girdle pain (P-trend = 0.046). Early timing of progestin-only contraceptive dispense following delivery (<= 3 months) was not significantly associated with persistent pelvic girdle pain.

Conclusions: Our findings suggest a small beneficial effect of progestin intrauterine devices and progestin-only oral contraceptives on recovery from pelvic girdle pain. We cannot completely rule out an opposing adverse effect of exposure to progestin injections and/or progestin implants. However, the modest increased odds of persistent pelvic girdle pain among these users could be a result of unmeasured confounding.

Place, publisher, year, edition, pages
2017. Vol. 12, no 9, article id e0184071
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Obstetrics, Gynecology and Reproductive Medicine
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URN: urn:nbn:se:uu:diva-335197DOI: 10.1371/journal.pone.0184071ISI: 000410243200009PubMedID: 28892506OAI: oai:DiVA.org:uu-335197DiVA, id: diva2:1163230
Available from: 2017-12-06 Created: 2017-12-06 Last updated: 2018-01-19Bibliographically approved

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