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268: Obstetric outcome in women who conceived with an intra uterine device

  • Hadas Ganer
    Affiliations
    Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel, Israel
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  • Amalia Levy
    Affiliations
    Department of Epidemiology and Health services Evaluation, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel, Israel
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  • Iris Ohel
    Affiliations
    Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel, Israel
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  • Eyal Sheiner
    Affiliations
    Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel, Israel
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      Objective

      To investigate pregnancy outcome in patients who conceived with an intra uterine contraceptive device (IUD).

      Study Design

      A retrospective study was performed comparing pregnancy outcomes in 3 groups: pregnancies of women with IUDs, women following IUD removal during early pregnancy and pregnancies without IUD. The linear-by-linear association test was used to assess association between the three groups and selected outcomes. Multiple logistic regression models were used to control for confounders.

      Results

      Out of 141,483 singleton gestations, 292 were of women who conceived with an IUD. The IUD was removed in 194 women during early pregnancy, and was retained in 98 women. A significant linear association was documented between the groups and selected pregnancy outcomes (Table). While controlling for confounders using multiple logistic regression models, both, IUD removal and retained IUD, were found as independent risk factors for preterm delivery (adjusted OR=2.1; 95% CI 1.4-3.7, and 2.8; 95% CI 1.7-4.7, respectively) and chorioamnionitis (adjusted OR=3.1; 95% CI 1.2-7.4, and 6.8; 95% CI 2.8-16.1, respectively).
      Tabled 1Pregnancy outcomes of women with and without IUD
      With IUD n=98Following IUD removal n=194No IUD n=141,191P value
      PROM10.2%7.7%5.7%0.020
      Chorioamnionitis7.1%4.1%0.7%<0.001
      Preterm delivery<37weeks18.4%14.4%7.3%<0.001
      Cesarean delivery31.6%20.6%12.8%<0.001
      Apgar<7 at 5 minutes3.1%0.5%0.5%0.020
      Congenital malformations10.2%5.7%5.1%0.040

      Conclusion

      Conceiving with an IUD is an independent risk factor for preterm delivery and chorioamnionitis. The risk is higher for pregnancies with retained IUD as compared to early IUD removal. Women conceiving with an IUD should be informed regarding these outcomes and careful surveillance as high-risk is warranted.