Association of body mass index with removal of etonogestrel subdermal implant

BackgroundBleeding irregularities represent the most common etonogestrel subdermal implant (ESI) removal indication.Study DesignESI placements (n= 304) from June 2007 to April 2011 were grouped by removal indications. Group characteristics were compared using one-way analysis of variance, Kruskal–Wallis and χ2 test.ResultsOf 304 insertions, 30.6% reported irregular bleeding. Removal indications included bleeding (Group 1, n= 50), side effects (Group 2, n= 17) and desired pregnancy/no need (Group 3, n= 25). Group 4 kept (n= 198) or reinserted (n= 14) ESI. Median body mass index was lower for Group 1 compared to other groups (p=.012). Group 3 was older than Group 1 or 4 (p=.021), and more likely parous (p<.001) and postpartum (p=.001) than other groups. Lactational placement was more common in Group 3 than 4 (p<.001). Obese women were 2.6 times less likely to remove ESI for bleeding vs. normal-weight or overweight women (95% confidence interval, 1.2–5.7; p=.014).ConclusionsAfter adjusting for age and parity, obese women were less likely to have ESI removal for bleeding.