Mifepristone versus other interventions for the prevention of pregnancy in reproductive‐age women using emergency contraception

This Cochrane systematic review compared the effectiveness, safety, and acceptability of mifepristone with other emergency contraceptive methods. The study included 87 randomized controlled trials with approximately 36,000 participants, mostly conducted in China. Low-dose mifepristone (less than 25 mg) compared to levonorgestrel led to reduced pregnancy rates with high certainty of evidence and significantly reduced side effects. Mid-dose mifepristone (25 to 50 mg) also likely reduced pregnancy rates and side effects compared to levonorgestrel. Mifepristone compared to the Yuzpe regimen (estrogen and progestin) probably substantially reduced pregnancy rates and side effects. However, all doses of mifepristone increased the risk of delayed menstruation. Data comparing mifepristone with copper intrauterine devices were limited.