title: The prognosis of pregnancy conceived despite the presence of an intrauterine device (IUD).
abstract: Intrauterine devices (IUDs) are used for contraception worldwide; however, the management of pregnancies with an IUD poses a clinical challenge. The purpose of this study was to determine the outcome of pregnancy in patients with an IUD.
  
  
  
  A retrospective cohort study (December 1997-June 2007) was conducted. The cohort consisted of 12,297 pregnancies, of which 196 had an IUD. Only singleton pregnancies were included. Logistic regression analysis was used to adjust for potential confounders between the groups.
  
  
  
  1) Pregnancies with an IUD were associated with a higher rate of late miscarriage, preterm delivery, vaginal bleeding, clinical chorioamnionitis, and placental abruption than those without an IUD; 2) among patients with available histologic examination of the placenta, the rate of histologic chorioamnionitis and/or funisitis was higher in patients with an IUD than in those without an IUD (54.2% vs. 14.7%; P<0.001). Similarly, among patients who underwent an amniocentesis, the prevalence of microbial invasion of the amniotic cavity (MIAC) was also higher in pregnant women with an IUD than in those without an IUD (45.9% vs. 8.8%; P<0.001); and 3) intra-amniotic infection caused by Candida species was more frequently present in pregnancies with an IUD than in those without an IUD (31.1% vs. 6.3%; P<0.001).
  
  
  
  Pregnant women with an IUD are at a very high risk for adverse pregnancy outcomes. This finding can be attributed, at least in part, to the high prevalence of intra-amniotic infection and placental inflammatory lesions observed in pregnancies with an IUD.
authors: Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA.
authors: Sun Kwon
authors: SK
authors: Kim
authors: Roberto
authors: R
authors: Romero
authors: Juan Pedro
authors: JP
authors: Kusanovic
authors: Offer
authors: O
authors: Erez
authors: Edi
authors: E
authors: Vaisbuch
authors: Shali
authors: S
authors: Mazaki-Tovi
authors: Francesca
authors: F
authors: Gotsch
authors: Pooja
authors: P
authors: Mittal
authors: Tinnakorn
authors: T
authors: Chaiworapongsa
authors: Percy
authors: P
authors: Pacora
authors: Giovanna
authors: G
authors: Oggé
authors: Ricardo
authors: R
authors: Gomez
authors: Bo Hyun
authors: BH
authors: Yoon
authors: Lami
authors: L
authors: Yeo
authors: Ronald F
authors: RF
authors: Lamont
authors: Sonia S
authors: SS
authors: Hassan
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000382:microbiology; D002677:Chile / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007434:Intrauterine Devices; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult