Depot Medroxyprogesterone Acetate Use and Blood Lead Levels in a Cohort of Young Women.
Journal
Environmental health perspectives
ISSN: 1552-9924
Titre abrégé: Environ Health Perspect
Pays: United States
ID NLM: 0330411
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
entrez:
18
11
2020
pubmed:
19
11
2020
medline:
11
2
2021
Statut:
ppublish
Résumé
Injectable contraceptive use is common, with 74 million users worldwide. Use of the injectable contraceptive depot medroxyprogesterone acetate (DMPA) is associated with bone mineral density loss. We hypothesize that increased bone resorption with DMPA use allows for mobilization of the toxic metal lead stored in bone to blood, presenting users with increased systemic exposure to lead. The objective of our study was to investigate the association between current DMPA use and blood lead concentrations. We conducted a cross-sectional analysis using enrollment data from the Study of Environment, Lifestyle & Fibroids (SELF), a cohort of 1,693 African-American women who were 23-35 years of age. Data on DMPA use were collected by computer-assisted telephone interview. Blood lead concentrations were measured in whole blood samples among 1,548 participants (91% of cohort). We estimated the adjusted percent difference in blood lead concentrations and 95% confidence intervals (CI) between current DMPA users and nonusers using multivariable linear regression. Geometric mean blood lead concentration was Our results indicate that current DMPA use is associated with increased blood lead concentrations. Further research, particularly in populations highly exposed to lead, is warranted to consider tradeoffs between the adverse effects of lead on human health and the importance of DMPA as a contraceptive option to prevent unintended pregnancy. https://doi.org/10.1289/EHP7017.
Sections du résumé
BACKGROUND
Injectable contraceptive use is common, with 74 million users worldwide. Use of the injectable contraceptive depot medroxyprogesterone acetate (DMPA) is associated with bone mineral density loss. We hypothesize that increased bone resorption with DMPA use allows for mobilization of the toxic metal lead stored in bone to blood, presenting users with increased systemic exposure to lead.
OBJECTIVE
The objective of our study was to investigate the association between current DMPA use and blood lead concentrations.
METHODS
We conducted a cross-sectional analysis using enrollment data from the Study of Environment, Lifestyle & Fibroids (SELF), a cohort of 1,693 African-American women who were 23-35 years of age. Data on DMPA use were collected by computer-assisted telephone interview. Blood lead concentrations were measured in whole blood samples among 1,548 participants (91% of cohort). We estimated the adjusted percent difference in blood lead concentrations and 95% confidence intervals (CI) between current DMPA users and nonusers using multivariable linear regression.
RESULTS
Geometric mean blood lead concentration was
DISCUSSION
Our results indicate that current DMPA use is associated with increased blood lead concentrations. Further research, particularly in populations highly exposed to lead, is warranted to consider tradeoffs between the adverse effects of lead on human health and the importance of DMPA as a contraceptive option to prevent unintended pregnancy. https://doi.org/10.1289/EHP7017.
Identifiants
pubmed: 33206002
doi: 10.1289/EHP7017
pmc: PMC7673223
doi:
Substances chimiques
Contraceptive Agents, Female
0
Environmental Pollutants
0
Lead
2P299V784P
Medroxyprogesterone Acetate
C2QI4IOI2G
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
117004Subventions
Organisme : NINR NIH HHS
ID : R00 NR017191
Pays : United States
Organisme : NIEHS NIH HHS
ID : R01 ES028235
Pays : United States
Organisme : ARRA NIH HHS
Pays : United States
Organisme : NIEHS NIH HHS
ID : R01 ES024749
Pays : United States
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