Abstract
Objective
The intrauterine device (IUD) is a commonly used method of reversible contraception worldwide. The objective of the study was to investigate pregnancy complications and perinatal outcomes in patients who conceived with an IUD.
Study Design
A retrospective population-based cohort study was conducted comparing the pregnancy outcome of women with retained intrauterine device, women after intrauterine device removal in early pregnancy and pregnancies without an intrauterine device. Deliveries occurred between the years 1991-2014 in a tertiary medical center. Multiple pregnancies, patients lacking prenatal care and neonates with congenital malformations or chromosomal abnormalities were excluded from the study. A multivariable generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders and for maternal clusters.
Results
During the study period there were 221,805 deliveries, of which 0.09% (n=203) and 0.06% (n=149) occurred in patients with removed or retained IUD, respectively. Women who conceived with an IUD were more likely to have preterm delivery (14.3% in the removed IUD, 14.1% in retained IUD and 6.8% in the no IUD group, p<0.001), chorioamnionitis (4.9% in removed IUD, 2.7% in the retained IUD and 0.6% in the no IUD group, p<0.001), low birth weight (11.3% in removed IUD ,12.1% in the retained IUD and 6.6% in the no IUD group, p=0.001) and perinatal mortality (2.0% in the removed IUD, 1.3% in retained IUD and 0.5% in the no IUD group, p=0.004; Table). Using a GEE model, controlling for confounders such as maternal age and hypertensive disorders of pregnancy, both removed and retained IUD were noted as an independent risk factor for preterm delivery (OR=2.2, 95% CI 1.4-3.2, P<0.001 and OR 2.3=, 95% CI 1.4-3.8, P<0.001 for removed and retained IUD, respectively).
Conclusion
Women conceiving with an intrauterine device are at an increased risk for adverse perinatal outcome, including preterm delivery, chorioamnionitis and perinatal mortality. Careful surveillance is required in these pregnancies.
The intrauterine device (IUD) is a commonly used method of reversible contraception worldwide. The objective of the study was to investigate pregnancy complications and perinatal outcomes in patients who conceived with an IUD.
Study Design
A retrospective population-based cohort study was conducted comparing the pregnancy outcome of women with retained intrauterine device, women after intrauterine device removal in early pregnancy and pregnancies without an intrauterine device. Deliveries occurred between the years 1991-2014 in a tertiary medical center. Multiple pregnancies, patients lacking prenatal care and neonates with congenital malformations or chromosomal abnormalities were excluded from the study. A multivariable generalized estimating equation (GEE) logistic regression model analysis was used to control for confounders and for maternal clusters.
Results
During the study period there were 221,805 deliveries, of which 0.09% (n=203) and 0.06% (n=149) occurred in patients with removed or retained IUD, respectively. Women who conceived with an IUD were more likely to have preterm delivery (14.3% in the removed IUD, 14.1% in retained IUD and 6.8% in the no IUD group, p<0.001), chorioamnionitis (4.9% in removed IUD, 2.7% in the retained IUD and 0.6% in the no IUD group, p<0.001), low birth weight (11.3% in removed IUD ,12.1% in the retained IUD and 6.6% in the no IUD group, p=0.001) and perinatal mortality (2.0% in the removed IUD, 1.3% in retained IUD and 0.5% in the no IUD group, p=0.004; Table). Using a GEE model, controlling for confounders such as maternal age and hypertensive disorders of pregnancy, both removed and retained IUD were noted as an independent risk factor for preterm delivery (OR=2.2, 95% CI 1.4-3.2, P<0.001 and OR 2.3=, 95% CI 1.4-3.8, P<0.001 for removed and retained IUD, respectively).
Conclusion
Women conceiving with an intrauterine device are at an increased risk for adverse perinatal outcome, including preterm delivery, chorioamnionitis and perinatal mortality. Careful surveillance is required in these pregnancies.
| Original language | English GB |
|---|---|
| Pages (from-to) | S73-S73 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 218 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2018 |