Abstract
Objective
The intrauterine device (IUD) is a commonly used method of reversible contraception worldwide. Pregnancy with an IUD in situ is a risk factor for adverse pregnancy outcome. The purpose of the current study was to examine a possible association between the presence of IUD during pregnancy and long-term infectious morbidity of the offspring.
Study Design
A population-based cohort analysis was performed including all singleton deliveries occurring between 1991-2014 at a single tertiary medical center. The primary exposure was defined as delivery of an infant to a mother conceived with an IUD that has been either removed or has not been removed. Offspring of mothers who conceived without an IUD comprised the comparison (unexposed) group. The main outcome evaluated was infectious morbidity of the offspring up to the age of 18 years. A Kaplan-Meier survival curve was used to compare cumulative infectious morbidity incidence. A Cox proportional hazards model was conducted to control for confounders.
Results
During the study period 220,709 deliveries met the inclusion criteria, of which 0.09% (n= 199) were born to mothers who conceived with an IUD that was removed, and 0.06% (n=147) were born to mothers with a retained IUD. Long- term infections morbidity was comparable between the groups (12.2% in offspring to women with retained IUD, 12.1 % in the group of removed IUD, and 10.2% in the no-IUD group; P = 0.47; Table). Likewise, the Kaplan-Meier survival curve did not demonstrate a significantly higher cumulative incidence of infectious morbidity in offspring of women conceiving with an IUD (Figure, log rank p=0.233). In the Cox regression model, while controlling for confounders such as maternal age and preterm birth, delivery of a neonate to mother with an IUD was not found to be independently associated with long-term infectious morbidity of the offspring.
Conclusion
Offspring of women conceiving with an intrauterine contraceptive device are not at an increased risk for long-term infectious morbidity.
The intrauterine device (IUD) is a commonly used method of reversible contraception worldwide. Pregnancy with an IUD in situ is a risk factor for adverse pregnancy outcome. The purpose of the current study was to examine a possible association between the presence of IUD during pregnancy and long-term infectious morbidity of the offspring.
Study Design
A population-based cohort analysis was performed including all singleton deliveries occurring between 1991-2014 at a single tertiary medical center. The primary exposure was defined as delivery of an infant to a mother conceived with an IUD that has been either removed or has not been removed. Offspring of mothers who conceived without an IUD comprised the comparison (unexposed) group. The main outcome evaluated was infectious morbidity of the offspring up to the age of 18 years. A Kaplan-Meier survival curve was used to compare cumulative infectious morbidity incidence. A Cox proportional hazards model was conducted to control for confounders.
Results
During the study period 220,709 deliveries met the inclusion criteria, of which 0.09% (n= 199) were born to mothers who conceived with an IUD that was removed, and 0.06% (n=147) were born to mothers with a retained IUD. Long- term infections morbidity was comparable between the groups (12.2% in offspring to women with retained IUD, 12.1 % in the group of removed IUD, and 10.2% in the no-IUD group; P = 0.47; Table). Likewise, the Kaplan-Meier survival curve did not demonstrate a significantly higher cumulative incidence of infectious morbidity in offspring of women conceiving with an IUD (Figure, log rank p=0.233). In the Cox regression model, while controlling for confounders such as maternal age and preterm birth, delivery of a neonate to mother with an IUD was not found to be independently associated with long-term infectious morbidity of the offspring.
Conclusion
Offspring of women conceiving with an intrauterine contraceptive device are not at an increased risk for long-term infectious morbidity.
| Original language | English GB |
|---|---|
| Pages (from-to) | S418-S419 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 220 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2019 |