Risk factors of the expulsion or the downward shift of the commonly used intrauterine device:a nested case-control study
Objective:To analyze the risk factors of the expulsion or the downward shift of the commonly used intrau-terine devices(IUD).Methods:A nested case-control study was established for the women who had been inserted the top 10 number of IUD types based on their IUD first-diagnosed registration from 2015 to 2020,and these women were included in the cohorts of this study.The results of the corresponding examinations were collected retrospectively or prospectively.There were 994 women with the expulsion or the downward shift of IUD in the case group,and the women matched in the control group according to 1:3.The conditioned logistic regression analysis model was used to screen out the suspicious risk factors of the expulsion or the downward shift of IUD.Results:The type of IUD,the history of cesarean section,the side effect and the lactation of the women were all the influencing factors of the expul-sion or the downward shift of their IUD.The risk of the expulsion or the downward shift of GCu200(odds ratio(OR)=2.01,95％CI 1.36-2.96),GCu220(OR=1.60,95％CI 1.08-2.37),OCu200(OR=2.00,95％CI 1.25-3.22),TCu220C(OR=1.56,95％CI 1.10-2.23),fixed IUD(OR=2.00,95％CI 1.36-2.95),active 165(OR=2.43,95％CI 1.62-3.64),Gamma Cu IUD(OR=1.77,95％CI 1.21-2.59)and YCu 200(OR=1.45,95％CI 1.02-2.06)was signifi-cantly higher than that of active Gamma Cu IUD(memory alloy).The risk of the expulsion or the downward shift of GCu220(OR=1.67,95％CI 1.07-2.60)or fixed IUD(OR=1.66,95％CI 1.06-2.61)was significantly higher than that of HCu280.The risk of the expulsion or the downward shift of GCu220(OR=0.66,95％CI 0.45-0.97),HCu280(OR=0.50,95％CI 0.31-0.79),TCu220C(OR=0.64,95％CI 0.45-0.92)and the Yuan Cu 200IUD(OR=0.60,95％CI 0.42-0.85)was significantly lower than that of active 165 IUD.The history of cesarean section(OR=1.29,95％CI 1.09-1.52),the side effect after IUD inserted(OR=3.55,95％CI 2.80-4.49)and the lactation(OR=4.62,95％CI 1.09-19.63)increased the risk of the expulsion or the downward shift of IUD.Conclusion:It is suggested that the appropri-ate type and the model of IUD should be selected for the women according to the risk factors of the expulsion or down-ward shift of their IUD,so as to improve the reproductive health level of the women of childbearing age.
Intrauterine devicesExpulsionDownward shiftRisk factorNested case-control study
万方数据
维普
