Follow-up visits after IUD insertion. Are more better?
OBJECTIVE
To determine whether frequent follow-up visits for intrauterine device (IUD) users prevents the development of pelvic inflammatory disease (PID).


METHODS
A prospective, cohort design was used to study 1,713 women who received an IUD in 1992 in Mexico. They were divided into two different follow-up regimens and were asked to return for either two or four revisits in the first year after insertion. The main outcome measures included incidence of PID and asymptomatic/symptomatic lower genital tract infections. Time to detection of lower genital tract infections was measured in a proportional hazards regression model; this analysis achieved 90% power to detect differences between the regimens.


RESULTS
The two regimens were nearly identical in terms of PID incidence. The incidence rates for asymptomatic and symptomatic lower genital tract infection were slightly higher in the four-visit regimen; however, the incidence rate ratios were not statistically elevated: 1.41 (0.77-2.56) and 1.23 (0.67-2.27), respectively. In the regression, the variable denoting follow-up regimen was not associated with time to detection of lower genital tract infection.


CONCLUSIONS
More follow-up visits for IUD users provide no benefit in terms of preventing PID or progression toward the disease.
Hubacher
D
D
Family Health International, Research Triangle Park, NC 27709, USA. dhubacher@fhi.org
Fortney
J
J
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000209:etiology; D007435:Intrauterine Devices, Copper / Q000009:adverse effects*; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis / Q000209:etiology; D010808:Physical Examination; D011446:Prospective Studies; D012307:Risk Factors