Impact of immediate postabortal insertion of intrauterine contraception on repeat abortion

被引:128
作者
Goodman, Suzan [1 ]
Hendlish, Sarah K. [2 ]
Reeves, Matthew F. [3 ,4 ]
Foster-Rosales, Anne [1 ,2 ]
机构
[1] Univ Calif San Francisco, San Francisco, CA 94110 USA
[2] Planned Parenthood Golden Gate, San Francisco, CA 94109 USA
[3] Univ Pittsburgh, Sch Med, Pittsburgh, PA 15261 USA
[4] Magee Womens Res Inst, Pittsburgh, PA 15261 USA
关键词
repeat abortion; IUD; IUC; intrauterine contraception; postabortal;
D O I
10.1016/j.contraception.2008.03.003
中图分类号
R71 [妇产科学];
学科分类号
100211 [妇产科学];
摘要
Background: Of the 1.3 million abortions performed annually in the United States, approximately half are repeat procedures. Immediate postabortal intrauterine device (IUD) insertion is a safe, effective, practical and underutilized intervention that we hypothesize will significantly decrease repeat unintended pregnancy and abortion. Study design: All women receiving immediate postabortal IUD insertion in eight clinics of a Northern California Planned Parenthood agency during a 3-year period comprise the IUD cohort. We selected a cohort of controls receiving abortions but choosing other, non-IUD contraception on the day of the abortion visit in a 2:1 ratio matched by date of abortion. We obtained follow-up data on repeat abortions within the agency for both cohorts through 14 months after the 3-year period. We evaluated differences in repeat abortion between cohorts. All analyses were intent-to-treat. Results: Women who received an immediate postabortal IUD had a lower rate of repeat abortions than controls (p<.001). Women who received a postabortal IUD had 34.6 abortions per 1000 woman-years of follow-up compared to 91.3 for the control group. The hazard ratio for repeat abortion was 0.38 [95% confidence interval (0), 0.27-0.53] for women receiving a postabortal IUD compared to controls. When adjusted for age, race/ethnicity, marital status, and family size, the hazard ratio was 0.37 (95% CI, 0.26-0.52). Conclusion: Immediate postabortal intrauterine contraception has the potential to significantly reduce repeat abortion. (c) 2008 Elsevier Inc. All rights reserved.
引用
收藏
页码:143 / 148
页数:6
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