Exposure to progestogen-only injectable contraception in pregnancy

Seek expert advice.

The SPC for Depo-Provera states that infants born from accidental pregnancies that occur 1-2 months after injection may be at increased risk of low birth weight and neonatal death (1)

• based on an observational study130 of Thai DMPA users in which the authors acknowledge the difficulties of adjusting for confounding variables such as differences in antenatal care, socioeconomic status, smoking and alcohol use among DMPA users and controls. Longer-term follow-up of the same group of children showed no evidence of any adverse effects on their growth or pubertal development
• other observational data have not shown any adverse effects on physical, intellectual, sexual or social development of children exposed to DMPA in utero and followed to adolescence

NICE (2) recommend that if a pregnancy occurs while using progestogen-only injectable contraception women should be advised that there is no evidence of harm to the pregnancy or fetus

Reference:

• FSRH (April 2019). Progestogen-only Injectable Contraception
• NICE (September 2014). Long-acting reversible contraception (update).