title: Retrospective review of intrauterine device in adolescent and young women.
abstract: OBJECTIVE
  To examine our experience with intrauterine device (IUD) use in adolescents and young women.
  
  
  METHODS
  Retrospective descriptive study evaluating outcomes after IUD insertion for patients 21 years or less over an 8-year period.
  
  
  METHODS
  Three sites including a Pediatric and Adolescent gynecology private practice, a Title X clinic, and community based, grant funded clinic serving a high risk teen population.
  
  
  METHODS
  Females from menarche to age 21.
  
  
  METHODS
  The probability of IUD retention, differences in IUD retention probabilities between two age groups, and risk factors for IUD removal, expulsion, and infection were evaluated.
  
  
  RESULTS
  233 records showed 50% of the <18-year-old age group and 71.5% of the 18-21-year-old group had their IUD in place at 5 years. Age was found to be a significant factor for removal (P < 0.001), with under 18-year-olds at greater risk of removal/expulsion (hazard ratio (HR) = 2.85). Parity (RR = 5.6 for nulliparous vs multiparous patients, P < 0.001) and prior STI (RR = 5.5, P < 0.001) were significant risk factors for infection. Nulliparous patients were at higher risk of expulsion (P = 0.045), though age was not a statistically significant risk factor.
  
  
  CONCLUSIONS
  The rate of continuation was lower in adolescents under 18 compared to 18-21-year-olds, but was still higher than for other hormonal contraceptives. Despite this groups' high risk for STI the IUD did not increase the risk of infection and may offer some degree of protection. IUDs appear to be a safe option in young adolescents (<18 years old) and nulliparous women.
authors.affiliation: University of Louisville, School of Medicine Department of Pediatrics, Louisville, KY, USA.
authors.forename: Tia M
authors.initials: TM
authors.lastname: Alton
authors.forename: Guy N
authors.initials: GN
authors.lastname: Brock
authors.forename: Dake
authors.initials: D
authors.lastname: Yang
authors.forename: Danica A
authors.initials: DA
authors.lastname: Wilking
authors.forename: S Paige
authors.initials: SP
authors.lastname: Hertweck
authors.forename: Meredith B
authors.initials: MB
authors.lastname: Loveless
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D003271:Contraceptive Agents, Female; D005260:Female; D006801:Humans; D007433:Intrauterine Device Expulsion; D007436:Intrauterine Devices, Medicated / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D016912:Levonorgestrel; D015999:Multivariate Analysis; D010298:Parity; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D016012:Poisson Distribution; D011247:Pregnancy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel