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What risks are there to your baby if you get pregnant while taking Depo Provera or Norplant?
The expert answers
The first studies examining fetal risk were conducted in the early 1970's and initially reported a link to isolated cardiac anomalies and the VACTERL complex. VACTERL refers to a malformation complex of Vertebral, Anal, Cardiac, Tracheo-Esophageal, Renal and Limb anomalies.
In 1990, two major studies were published that provided a thorough and critical review of data involving pregnancies and exposures to contraceptive steroids. The first study (Simpson/Phillips,1990) found no relation between oral contraceptive pills and the following problems: hypospadias, limb reduction anomalies, neural tube defects or chromosomal anomalies. Virilization of a female fetus was found not be a risk either, as the doses required (20 to 40 milligrams of Norethindrone per day) are far in excess of any currently used contraceptive available today.
A meta-analysis* of 26 prospective studies (Bracken, 1990) concluded that there was no increased risk for major malformations, congenital heart defects or limb reductions in pregnancies that occurred while the mother was on hormonal contraceptives.
The risk of significant congenital anomalies is 3 to 4 percent in the baseline population. For women who conceive while using a contraceptive, there is no greater risk for these anomalies. This is true for women on oral contraceptive pills, Norplant or Depo-Provera.
* -- Meta-analysis -- a clinical study that combines similar studies together and reprocesses the collected data. The increased population size in the study gives the combined data more statistical significance in drawing clinical conclusions.