IUD use among parous women and risk of uterine perforation: a secondary analysis.
OBJECTIVE
The objective of the study was to determine if delivery and lactation are risk factors for complete intrauterine device perforations.


METHODS
We performed a reanalysis of the European Active Surveillance Study on Intra-Uterine Devices data set using complete penetration of the myometrium as the definition for perforation.


RESULTS
Of the 61,448 women enrolled (70% levonorgestrel, 30% copper devices), we identified 58 complete perforations, 30 of which occurred in lactating women. Incidence per 1000 insertions was 4.5 (95% confidence interval [CI]: 3.0-6.4) for lactating and 0.6 (95% CI: 0.4-0.9) for nonlactating women. Time since delivery was also associated with perforation risk.


CONCLUSIONS
Lactation and delivery are independent cofactors for perforation. Results do not differ when restricting the definition of perforation.
ZEG - Berlin Center for Epidemiology and Health Research, Berlin, Germany. Electronic address: k.heinemann@zeg-berlin.de.
Klaas
K
Heinemann
ZEG - Berlin Center for Epidemiology and Health Research, Berlin, Germany.
Clare
C
Barnett
ZEG - Berlin Center for Epidemiology and Health Research, Berlin, Germany.
Suzanne
S
Reed
ZEG - Berlin Center for Epidemiology and Health Research, Berlin, Germany.
Sabine
S
Möhner
ZEG - Berlin Center for Epidemiology and Health Research, Berlin, Germany.
Thai
T
Do Minh
D001942:Breast Feeding; D066264:Datasets as Topic; D036861:Delivery, Obstetric; D005060:Europe; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D007435:Intrauterine Devices, Copper / Q000009:adverse effects; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects; D007774:Lactation; D016912:Levonorgestrel / Q000008:administration & dosage; D012307:Risk Factors; D013997:Time Factors; D014595:Uterine Perforation / Q000453:epidemiology* / Q000209:etiology*
D016912:Levonorgestrel
Active surveillance; Breastfeeding; Childbirth; IUD; Levonogestrel; Prospective cohort study