1. Depo Provera and Weight Gain: A cross-sectional study of the association of DMPA use on in reproductive-aged Non-Hispanic White and Non-Hispanic Black women Janet Ross, Jenifer Allsworth UMKC School of Medicine Introduction Depot medroxyprogesterone acetate (DMPA) is a progestin-only contraceptive that is highly effective in the prevention of pregnancy. One in four women in the United States have a history of injectable use. Conflicting findings from randomized trials and epidemiologic studies have resulted in an ongoing debate regarding the effect of DMPA on weight gain. The goal of this study was to examine, using a nationally representative sample, whether DMPA was associated with higher odds of obesity and increased weight gain among reproductive aged women who identify either as Non-Hispanic White and Non-Hispanic Black. Methods Data from National Health and Nutrition Examination Survey, NHANES, 1999-2010 were included in this analysis. Inclusion criteria: non-pregnant women between the ages of 16 and 45 Exposure: self-reported history of using DMPA use (Depo-Provera ® ) Outcomes: Weight change in the last year (current - prior year self-reported weights) Overweight/obesity was defined as measured body mass index ≥ 25 kg/m 2 Multivariable logistic and linear regression models that adjusted for the complex survey characteristics were estimated using STATA Results 6,674 women were included in this analysis 14% of women had a history of DMPA use Non-Hispanic Black women reported higher rates of DMPA use than non-Hispanic White women (23% vs. 12%) Women with a history of DMPA use were somewhat more likely to be overweight or obese (OR 1.22 CI 0.99, 1.5) compared to women who did not have a history of DMPA after adjusting for race/ethnicity and age Weight change in the last year was not associated with DMPA use after adjusting for race/ethnicity and age Summary Conclusion Women with a history of DMPA use were more likely to be overweight or obese than women who had never used this form of contraception. The effect of DMPA on weight is likely short-term as there were no differences in recent weight gain among women with a history of DMPA use when race and age were adjusted for. Clinicians should counsel patients regarding the risk of weight gain when prescribing DMPA. Interventions that prevent weight gain during DMPA are needed. References 1.Lopez LM, Edelman A, Chen M, Otterness C, Trussell J & Helmerhorst FM. (2013). Progestin- only contraceptives: effects on weight. Cochrane Database of Systematic Reviews 2013, Issue 7 Art. No.: CD008815. 2.Medline Plus. Medroxyprogesterone injection. Retrieved from http://www.nlm.nih.gov/medlineplus/ druginfo/meds/a604039.html on February 20, 2014 http://www.nlm.nih.gov/medlineplus/ druginfo/meds/a604039.html 3.Espey E, Steinhart J, Ogburn T, Qualls C (2000). Depo-Provera associated with weight gain in Navajo women. Contraception, 62: 55-58 4.Vickery Z, Madden T, Zhao Q, Secura G, Allsworth JE, Peipert JF (2013). Weight changes at 12 months in users of three progestin- only contraceptive methods. Contraception; 88: 503-508. 5.Risser WL, Gefter LR, Barratt MS, Resser JMH (1999). Weight change in adolescents who used hormonal contraception. J Adol. Hlth; 24: 433-436 6.Beksinksa ME, Smit JA, Kleinschmidt I, Milford C, Farley TMM (2010). Prospective study of weight change in new adolescent users of DMPA, NET-EN, COCs, nonusers and discontinuer of hormonal contraception. Contraception; 81: 30-34 Change in weightCoef.Std. Err.tP>|t|95% Conf. Interval Depo Use-0.0090.170-0.060.956-0.35, 0.33 Age-0.0020.077-0.030.765-0.02, 0.01 Non-Hispanic Black0.5120.2052.500.0140.10, 0.92 BMI CategoryNon-Hispanic White Depo Users Non-Hispanic Black Depo Users Underweight5%3% Normal Weight47%27% Overweight22%24% Obese26%45%