Rates of Intrauterine Device Expulsion Among Adolescents and Young Women
Journal of Pediatric and Adolescent Gynecology(2021)
Abstract
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.
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Key words
Intrauterine device expulsion,Abnormal uterine bleeding,Heavy menstrual bleeding,Adolescent
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