IUD-associated hospitalization in less developed countries.

Area of Science:

• Reproductive Health
• Medical Device Safety
• Global Health

Background:

• Intrauterine devices (IUDs) are widely used contraceptives, particularly in less developed countries (LDCs).
• Understanding IUD-associated hospitalization risks is crucial for patient safety and public health initiatives.
• Previous data on IUD complications requiring hospitalization in LDCs is limited.

Purpose of the Study:

• To investigate the incidence and indications of hospitalizations associated with intrauterine device (IUD) use.
• To analyze IUD-associated hospitalization rates across various demographic factors and device types in LDCs.

Main Methods:

• Retrospective analysis of data from 11,977 intrauterine device (IUD) insertions across 25 centers in 16 less developed countries (LDCs).
• Inclusion criteria required centers to report at least one IUD-associated hospitalization with regular follow-up.
• Calculation of hospitalization rates using Pearl Index, one-year life table, and crude rates.

Main Results:

• Of 128 reported hospitalizations, 55 were associated with IUD use, primarily for pelvic infection, bleeding/pain, or method failure.
• No statistically significant differences in hospitalization rates were found based on age, parity, or IUD type (Lippes Loop, Copper T, Delta devices).
• Calculated IUD-associated hospitalization rates included a Pearl rate of 8.0/1,000 woman-years, a one-year life table rate of 6.3/1,000 insertions, and crude rates of 3.2-4.6/1,000 cases.

Conclusions:

• Intrauterine device (IUD) use in less developed countries (LDCs) is associated with a low overall hospitalization rate for complications.
• Common reasons for IUD-related hospitalizations include infection, pain, and bleeding, irrespective of patient age, parity, or specific device type.
• The findings support the safety profile of IUDs in LDC settings, with infrequent need for inpatient care.