Effectiveness, safety and acceptability of mifepristone compared with other interventions in reproductive-age women using emergency contraception for the prevention of pregnancy: a systematic review and meta-analysis.
BMJ Sex Reprod HealthSep 23, 2026 (epub)
Clinical ResearchObstetrics & Gynecology
Shaalini Ramanadhan, Alison Edelman, Yan Che et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the effectiveness, safety, and acceptability of mifepristone compared to other emergency contraception methods in reproductive-age women. Analyzing 87 trials with approximately 36,000 participants, mifepristone significantly reduced pregnancy risk compared to the Yuzpe regimen (RR 0.14) and was more effective than low-dose and mid-dose levonorgestrel.
Key findings
- Mifepristone reduced pregnancy risk compared to the Yuzpe regimen (RR 0.14, 95% CI 0.05 to 0.41).
- Mifepristone was more effective than low-dose levonorgestrel (<25 mg; RR 0.73, 95% CI 0.59 to 0.90).
- Mifepristone was more effective than mid-dose levonorgestrel (25-50 mg; RR 0.67, 95% CI 0.49 to 0.91).
- Mifepristone causes less nausea and vomiting than the Yuzpe regimen.
Why it matters
Understanding the comparative effectiveness and safety of emergency contraceptive options is crucial for clinicians to provide informed counseling to women seeking to prevent unintended pregnancies after unprotected intercourse.