The Efficacy of Emergency Contraception to Prevent Pregnancy: A Systematic Review and Meta-Analysis

Simanjuntak, Tigor Peniel and Sihaloho, Resilia and Sirait, Batara I. (2023) The Efficacy of Emergency Contraception to Prevent Pregnancy: A Systematic Review and Meta-Analysis. Indonesian Journal of Obstetrics & Gynecology Science, 6 (3). pp. 346-354. ISSN 2615 496X

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Abstract

Objective: A systematic review and meta-analysis to determine the effectiveness of various emergency contraceptive methods to prevent pregnancy. Method: This study followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) protocol. Data search used four databases, namely Pubmed, Google Scholar, Science Direct, and Wiley. Data that met the inclusion criteria were subjected to meta-analysis to analyze the combined proportion of data using MedCalc 20.012 software, calculation of a percentage of 95% Confidence Intervals (CI) and P<0.05, and heterogeneity test between studies. Results: There were 6 journals that met the criteria. Some of the contraceptives used as emergency contraception are: the copper IUD (CuIUD) with effectiveness reaching 100% in preventing pregnancy, levonorgestrel (LNG) 52-mg IUS with effectiveness reaching 99.95%, the levonorgestrel (LNG) 52-mg IUD with effectiveness reaching 99.7%, mifepristone 10 mg with effectiveness reaching 99.3%, mifepristone 5 mg with effectiveness reaching 98.8%, ulipristal acetate (UPA) 30 mg in pre-ovulatory women with effectiveness reaching 98.6%, levonorgestrel (LNG) 0.75 mg with effectiveness reaching 98.3%, yuzpe regimen with effectiveness reaching 98.2%, and ulipristal acetate (UPA) 30 mg in post-ovulatory women with effectiveness reaching 97.9%. The results of the proportion meta-analysis showed the proportion of pregnancies after the use of emergency contraceptive, which was 0.231% (95% CI 0.116–0.384) from 4,927 samples in 6 studies, and the results of the heterogeneity test between studies were found to be not meaningful (I2 = 0%). Conclusion: The emergency contraception used to prevent pregnancy is very effective with the results of a meta�analysis of the proportion of 0.231% (95% CI 0.116–0.384). This suggests that the percentage of pregnancies after emergency contraceptive use is quite low. Key words: Effectiveness, Emergency Contraception / Tujuan: Tinjauan sistematis dan meta-analisis untuk mengetahui efektivitas berbagai metode kontrasepsi darurat untuk mencegah kehamilan. Metode: Penelitian ini mengikuti protokol Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). Pencarian data menggunakan empat database yaitu Pubmed, Google Scholar, Science Direct, dan Wiley. Data yang memenuhi kriteria inklusi dilakukan meta analisis dengan analisis proporsi gabungan data menggunakan software MeldCalc 20.012, dilakukan perhitungan persentase 95% CI dan P < 0.05, serta dilakukan uji heterogenitas antar studi. Hasil: Terdapat 6 jurnal yang memenuhi kriteria. Beberapa alat kontrasepsi yang digunakan sebagai kontrasepsi darurat yaitu: AKDR tembaga (CuIUD) dengan efektivitas mencapai 100% dalam mencegah kehamilan, levonorgestrel (LNG) 52-mg IUS dengan efektivitas mencapai 99,95%, levonorgestrel (LNG) 52-mg IUD dengan efektivitas mencapai 99,7%, mifepristone 10 mg dengan efektivitas mencapai 99,3%, mifepristone 5 mg dengan efektivitas mencapai 98,8%, ulipristal asetat (UPA) 30 mg pada wanita pre-ovulasi dengan efektivitas mencapai 98,6%, levonorgestrel (LNG) 0,75 mg dengan efektivitas mencapai 98,3%, yuzpe regimen dengan efektivitas mencapai 98,2%, dan ulipristal asetat (UPA) 30 mg pada wanita post-ovulasi dengan efektivitas mencapai 97,9%. Hasil meta analisis proporsi menunjukkan proporsi kehamilan setelah penggunaan kontrasepsi darurat yaitu 0,231% (95% CI 0,116–0,384) dari 4.927 sampel, serta hasil uji heterogenitas antar studi ditemukan tidak bermakna (I2 = 0%). Kesimpulan: Penggunaan kontrasepsi darurat sangat efektif dalam mencegah kehamilan dengan hasil meta analisis proporsi yaitu 0,231% (95%CI 0,116–0,384). Hasil tersebut menunjukkan bahwa persentase kehamilan setelah penggunaan kontrasepsi darurat cukup rendah. Kata kunci: Efektivitas, Kontrasepsi Darurat

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