Evidence map›Paper›PMID 33478494›Full record

Trial reportBMC women's health2021

Comparison of levonorgestrel level and creamatocrit in milk following immediate versus delayed postpartum placement of the levonorgestrel IUD.

Niaree G Hopelian, Rebecca G Simmons, Jessica N Sanders, Katherine Ward, Sabrina Malone Jenkins, Eve Espey, David K Turok

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC women's health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01990703 (Randomized Controlled Trial of Early Versus Standard Postpartum Insertion of the Levonorgestrel IUD to Assess Breast Feeding Outcomes), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01990703 phase4completednot on this map

Randomized Controlled Trial of Early Versus Standard Postpartum Insertion of the Levonorgestrel IUD to Assess Breast Feeding Outcomes (BLIS - Breastfeeding Levonorgestrel IUD Study)

TypeinterventionalSponsorUniversity of UtahRan2014 to 2017Enrolled285ConditionsContraceptionArmsLevonorgestrel IUD
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Niaree G Hopelian *The University of Utah School of Medicine, 30 N 1900 E, 2B200, Salt Lake City, UT, 84132, USA.
Rebecca G Simmons *Division of Family Planning, Department of Obstetrics and Gynecology, The University of Utah School of Medicine, 30 N 1900 E, 2B200, Salt Lake City, UT, 84132, USA.
Jessica N SandersDivision of Family Planning, Department of Obstetrics and Gynecology, The University of Utah School of Medicine, 30 N 1900 E, 2B200, Salt Lake City, UT, 84132, USA.
Katherine WardThe University of Utah College of Nursing, 10 S 2000 E, Salt Lake City, UT, 84112, USA.
Sabrina Malone JenkinsDivision of Neonatology, Department of Pediatrics, The University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT, 84108, USA.
Eve EspeyDepartment of Obstetrics and Gynecology, The University of New Mexico School of Medicine, Albuquerque, NM, 87131, USA.
David K TurokDivision of Family Planning, Department of Obstetrics and Gynecology, The University of Utah School of Medicine, 30 N 1900 E, 2B200, Salt Lake City, UT, 84132, USA. David.Turok@hsc.utah.edu.ORCID 0000-0002-6289-0542
University of Utah · USUniversity of New Mexico · US

Funding

Utah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0M
University of Utah Center for Clinical and Translational Science-UL1UL1TR000105 · NCATS · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2012 to 2013
$5.1M
Utah Building Interdisciplinary Resreach Careers in Women's Health Career Development ProgramK12HD085852 · NICHD · UNIVERSITY OF UTAH · PI VARNER, MICHAEL W. · 2015 to 2019
$2.3M
Midcareer Investigator Award in Patient-Oriented Research K24K24HD087436 · NICHD · UNIVERSITY OF UTAH · PI TUROK, DAVID · 2017 to 2021
$942k
NCATS NIH HHS UL1 TR000105NCATS NIH HHS UL1 TR002538NICHD NIH HHS K12 HD085852NICHD NIH HHS K24 HD087436
6 · The paper itself

Abstract

backgroundBreastfeeding and postpartum contraception critically influence infant and maternal health outcomes. In this pilot study, we explore the effects of timing and duration of postpartum levonorgestrel exposure on milk lipid and levonorgestrel content to establish baseline data for future research.

methodsThis sub-study recruited a balanced convenience sample from 259 participants enrolled in a parent randomized controlled trial comparing immediate to delayed (4-8 weeks) postpartum levonorgestrel IUD placement. All planned to breastfeed, self-selected for sub-study participation, and provided the first sample at 4-8 weeks postpartum (before IUD placement for the delayed group) and the second four weeks later. We used the Wilcoxon rank sum (inter-group) and signed rank (intra-group) tests to compare milk lipid content (creamatocrit) and levonorgestrel levels between groups and time points.

resultsWe recruited 15 participants from the immediate group and 17 from the delayed group with 10 and 12, respectively, providing both early and late samples. Initially, median levonorgestrel concentration of the immediate group (n = 10) (32.5 pg/mL, IQR: 24.8, 59.4) exceeded that of the delayed group (n = 12) (17.5 pg/mL, IQR: 0.0, 25.8) (p = 0.01). Four weeks later, the values aligned: 26.2 pg/mL (IQR: 20.3, 37.3) vs. 28.0 pg/mL (IQR: 25.2, 40.8). Creamatocrits were similar between both groups and timepoints.

conclusionsImmediate postpartum levonorgestrel IUD placement results in steady, low levels of levonorgestrel in milk without apparent effects on lipid content. These findings provide initial support for the safety of immediate postpartum levonorgestrel IUD initiation, though the study was not powered to detect noninferiority between groups.

trial registrationThis randomized controlled trial was registered with ClinicalTrials.gov (Registry No. NCT01990703) on November 21, 2013.

Indexed as

Contraceptive Agents, FemaleLevonorgestrelAnimalsFemaleHumansInfantMilkPilot ProjectsPostpartum PeriodContraceptive Agents, FemaleLevonorgestrelBreastfeedingCreamatocritHuman milkIntrauterine deviceLevonorgestrelPostpartum contraception

Identifiers

PMID33478494
PMCPMC7818753
OpenAlexW3124551503

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.