Objective: The objective of the study was to determine if delivery and lactation are risk factors for complete intrauterine device perforations.
Study design: We performed a reanalysis of the European Active Surveillance Study on Intra-Uterine Devices data set using complete penetration of the myometrium as the definition for perforation.
Results: Of the 61,448 women enrolled (70% levonorgestrel, 30% copper devices), we identified 58 complete perforations, 30 of which occurred in lactating women. Incidence per 1000 insertions was 4.5 (95% confidence interval [CI]: 3.0-6.4) for lactating and 0.6 (95% CI: 0.4-0.9) for nonlactating women. Time since delivery was also associated with perforation risk.
Conclusions: Lactation and delivery are independent cofactors for perforation. Results do not differ when restricting the definition of perforation.
Keywords: Active surveillance; Breastfeeding; Childbirth; IUD; Levonogestrel; Prospective cohort study.
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