Study Objective

The objective of our study was to determine the rate of intrauterine device (IUD) expulsion and risk factors for expulsion among adolescents and young adults.

Design

Retrospective chart review.

Setting

IUD insertions were performed at a single children's hospital.

Participants

Eligible adolescent and young adult patients who underwent IUD insertion between August 2009 and March 2019.

Interventions

IUD insertion.

Main Outcome Measures

Primary outcome was the incidence of IUD expulsion in adolescents and young women. Secondary outcomes were risk factors for IUD expulsion including heavy menstrual bleeding, abnormal uterine bleeding (AUB), anemia, or a bleeding disorder diagnosis.

Results

Six hundred forty-two eligible patients underwent IUD insertion. The incidence of first IUD expulsion in this population was 58/642 (9.03%). Among those who chose to have a second IUD placed (n = 29), 8/29 (27.6%) had a second expulsion. Patients who expelled their IUD were more likely to have a history of AUB, heavy menstrual bleeding, anemia, or a bleeding disorder. When controlled for body mass index and age at insertion, history of AUB and anemia remained significant risks for IUD expulsion.

Conclusion

This study similarly showed a higher risk of primary and secondary IUD expulsion in adolescents and young women. A history of AUB, anemia, bleeding disorder, and elevated body mass index are associated with higher risk for IUD expulsion. This population should be counseled that these conditions might place them at higher risk for expulsion.

中文翻译：

---

青少年和年轻妇女宫内节育器排出率

研究目的

我们研究的目的是确定青少年和年轻人中宫腔内器械（IUD）排出的速率和排出的危险因素。

设计

回顾性图表审查。

环境

在单个儿童医院进行宫内节育器插入。

参加者

在2009年8月至2019年3月之间接受宫内节育器插入的合格青少年患者。

干预措施

放置宫内节育器。

主要观察指标

主要结局是青少年和年轻妇女宫内节育器排出的发生率。次要结局是驱逐宫内节育器的危险因素，包括月经大量出血，子宫异常出血（AUB），贫血或出血性疾病的诊断。

结果

642例符合条件的患者接受了宫内节育器插入。该人群中首次IUD逐出的发生率为58/642（9.03％）。在选择放置第二个宫内节育器的人群（n = 29）中，有8/29（27.6％）被第二次驱逐。排出宫内节育器的患者更容易有AUB病史，月经大量出血，贫血或出血性疾病。如果控制体重指数和插入时的年龄，则AUB和贫血的病史仍然是IUD排出的重大风险。

结论

这项研究同样表明，青少年和年轻妇女的原发和继发宫内节育器排出风险较高。有AUB病史，贫血，出血性疾病和体重指数升高与IUD排出风险较高相关。应劝告该人群这些情况可能使他们面临更高的驱逐风险。