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Expulsion and continuation rates of the 52 mg levonorgestrel intrauterine system in adolescents and adult women

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Autor(es):
Brull, Eliza ; Machado, Helymar C. ; Bahamondes, Luis ; Juliato, Cassia R. T.
Número total de Autores: 4
Tipo de documento: Artigo Científico
Fonte: EUROPEAN JOURNAL OF CONTRACEPTION AND REPRODUCTIVE HEALTH CARE; v. 28, n. 4, p. 6-pg., 2023-06-13.
Resumo

ObjectiveTo compare the continuation rates, expulsion, and other reasons for discontinuation of the hormonal intrauterine device with 52 mg of levonorgestrel (52 mg LNG-IUD) in adolescents and adult women.MethodsWe conducted a retrospective cohort study that included 393 women in whom we placed a 52 mg LNG-IUD and followed up to 5 years. We created two retrospective cohorts, one with 131 adolescents (aged between 12 and 19 years) and the other with 262 women aged >= 20 years. Each adolescent was paired with two adult women who had the same parity and who had a 52 mg LNG-IUD inserted on the same day. We used the Mann-Whitney test to compare numerical variables in both groups, the Kaplan-Meier method, and the log-rank test to compare the continuation, expulsion and other reasons for IUD discontinuation of the two groups.ResultsAge of the adolescents and adult women were mean +/- SD 18.1 (+/- 1.1) and 31 (+/- 6.8) years, respectively (p = 0.015). Continuation rates by the fifth year of use were 55.6/100 women-years (W-Y) and 70.3/100 W-Y among adolescents and adult women (p = 0.106); and expulsion rates were 8.4/100 and 6.0/100 W-Y, respectively (p = 0.463). Adolescents had a lower continuation rate during 3 to 5 years of follow-up (p = 0.011) and a high rate of removals due to bleeding/pain (18.5 +/- 5.7/100 W-Y vs 6.4/100 +/- 2.1 W-Y, p = 0.039).ConclusionAdolescents who used the 52 mg LNG-IUD showed a lower continuation rate 3-5 years after device placement than adult women. The expulsion rates were similar in both groups. SHORT CONDENSATIONAdolescents who used the 52 mg LNG-IUD showed expulsion rates similar than adult women. Despite the good continuation rate, adolescents had a lower continuation rate within 3-5 years of follow-up and high rate of removals due to bleeding/pain than adult users. (AU)

Processo FAPESP: 20/14899-9 - Avaliar diversos aspectos clínicos do uso do sistema intrauterino de levonorgestrel 52mg (SIU-LNG)
Beneficiário:Gabriela de Oliveira Paez
Modalidade de apoio: Bolsas no Brasil - Iniciação Científica