Conception with intrauterine device increases adverse pregnancy outcomes
MedWire News: Women who conceive when using an intrauterine contraceptive device have an increased risk for adverse obstetric outcomes compared with other women, but the risk is reduced with early device removal, conclude Israeli researchers.
Hadas Ganer, from Joyce and Irving Goldman Medical School in Be’er-Sheva, and colleagues studied the medical records of 98 pregnant women with a retained intrauterine device (group 1), 194 women with intrauterine device removal in early pregnancy (group 2), and 141,191 pregnancies without an intrauterine device (group 3), comparing pregnancy outcomes.
The team found a significant linear association between the groups and adverse outcomes. For example, preterm delivery occurred in 18.4 percent of group 1 women, 14.4 percent of group 2 women, and 7.3 percent of group 3 women. In addition, chorioamnionitis occurred in 7.1 percent, 4.1 percent, and 0.7 percent of women, respectively.
On multivariate analysis taking into account maternal age and parity, intrauterine use and removal were both independent risk factors for preterm delivery before 37 weeks, at odds ratios of 2.2 and 2.6, respectively. They were also independent predictors of choriamnionitis, at odds ratios of 3.1 and 6.3, respectively.
The team says: “Women conceiving with an intrauterine device should be informed regarding these outcomes, because intrauterine device removal reduces the risk for adverse obstetric outcomes, but does not eliminate it.”
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By Liam Davenport