Application of contraceptive adverse reaction surveillance in effectiveness evaluation of intrauterine device
10.3760/cma.j.cn101441-20210309-00114
- VernacularTitle:避孕药具不良反应监测在宫内节育器有效性评价中的应用
- Author:
Lei BA
1
;
Wenhui SHI
1
;
Guanrong WANG
1
;
Jie LIN
1
;
Yuehua YANG
1
;
Jian ZHOU
1
;
Zhiming SUN
1
Author Information
1. 国家卫健委计划生育药具不良反应监测中心，江苏省卫生健康发展研究中心，南京 210036
- Publication Type:Journal Article
- Keywords:
Intrauterine device;
Unintended pregnancy;
Ectopic pregnancy;
Adverse events;
Effectiveness;
Recorded linkage
- From:
Chinese Journal of Reproduction and Contraception
2021;41(8):688-693
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze and evaluate the effectiveness of common intrauterine device (IUD), and to provide reference for clinical use of IUD.Methods:The IUD adverse events of unexpected pregnancy reported by the National Contraceptive Adverse Reaction Surveillance Sites in Jiangsu Province from 2011 to 2020 were collected, and the records were linked with the population database of IUDs placement in the region. The pregnancy incidence and cumulative incidence of different IUDs were compared to evaluate the contraceptive effect.Results:A total of 4788 pregnant women with 10 common IUDs were collected, and 294 834 IUDs were placed. Among the pregnant women, ectopic pregnancy accounted for 1.88% (90/4788); IUD expulsion and position change accounted for 16.90% (809/4788) and 32.31% (1547/4788) respectively. The incidence of pregnancy in the first year after IUD placement was 0.53%. The incidence of pregnancy in all kinds of IUDs (except for Anshu-IUD) decreased gradually with the extension of using time. The cumulative incidence of TCu220C in 3, 5, 8 years was significantly higher than the average incidence. The relative risk ( RR) was 1.45(95% CI=1.37-1.55), 1.35(95% CI=1.28-1.43) and 1.31(95% CI=1.24-1.38), respectively. Regardless of expulsion, Ginny's cumulative in 3, 5, 8 years and Hu280's cumulative 3- and 5-year incidence were significantly lower than the average level. Excluding expulsion, Ginny's RR was 0.58(95% CI=0.49-0.70), 0.55(95% CI=0.47-0.66) and 0.63(95% CI=0.53-0.75), Hu280's RR was 0.36(95% CI=0.25-0.51) and 0.45(95% CI=0.33-0.61), respectively. Conclusion:The common IUD has a good contraceptive effect, and Ginny and Hu280 are more effective. It is suggested that the imaging follow-up examination should be strengthened in the early stage of IUD placement to reduce the accidental pregnancy caused by expulsion and position change.
