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    Teens likely to request early IUD removal



    Intrauterine devices (IUDs) are an effective form of long-acting reversible contraception (LARC) with low complication rates, yet adolescents are more likely than adult women to request early removal of the devices, according to a new study in Obstetrics and Gynecology.

    Researchers from the Riverside Health System in Newport News, Virginia performed a multicenter retrospective chart review of teenagers and women aged 13 to 35 years who had undergone IUD insertion for contraception between June 2008 and June 2011. Of the 2523 charts review, 2138 patients were included in the analysis.

    After average follow up of 37±11 months, the overall rates of IUD expulsion or pregnancy were 6% and 1%, respectively. There was no significant difference by age or parity. Rates of discontinuation of IUDs were 19% at 12 months and 41% after the average follow-up of 37 months. Although rates of IUD removal were similar across all age groups at 12 months of usage, teenagers aged 13-19 years were more likely than others to request early removal at the end of the total follow-up period. No statistical differences were seen in rates of pelvic inflammatory disease (2%) based on age. Risks of explusion and contraceptive failure were higher with copper IUDs than with a  levonorgestrel intrauterine system (hazard ratios [HRs] 1.62, 95% confidence interval [CI] 1.06-2.50; HRs 4.89, 95% CI 2.02-11.80, respectively) after adjusting for age and parity.

    Concluding that teenagers were most likely to prematurely discontinue use of their IUD, the investigators urged physicians to provide additional counseling on the potential complications of IUDs as well as the benefits of LARCs.



    To get weekly advice for today's Ob/Gyn, subscribe to the Contemporary Ob/Gyn Special Delivery.

    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.


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