The long-term growth and development of children exposed to Depo-Provera during pregnancy or lactation

Children exposed to the injectable contraceptive Depo-Provera (DMPA) during pregnancy (N = 1,207), and/or during breastfeeding (N = 1,215) were compared to a control group composed of 1,167 children with no hormone exposures during pregnancy or breastfeeding. Weights and heights were measured for all children, and information on signs of puberty obtained for children aged ten and over. Cross-sectional weights and heights by age of DMPA-exposed children were similar to those for controls. Children with DMPA exposure during pregnancy and lactation had an increased risk of suboptimal growth in height, defined as less than two Z scores on NCHS standards (RR = 1.4, 95% CI 1.2-1.8). However, after adjustment for socioeconomic factors by multiple logistic regression, there was no increased risk of impaired growth among the DMPA-exposed children (RR = 1.1, 95% CI 0.8-1.6). With the exception of a delay in onset of reported pubic hair growth among DMPA-exposed girls, there were no significant effects on attainment of puberty. We conclude that use of DMPA during pregnancy or breastfeeding does not adversely affect the long-term growth and development of children.