TOP LINE:
Health care utilization after immediate postpartum intrauterine device (IUD) placement was similar, with the immediate group making fewer visits to obstetricians or physicians gynecologists (OB/GYNs). Although immediate placement was associated with increased rates of imaging, it showed lower rates of laparoscopic surgery for IUD-related complications.
WORK:
- Researchers conducted a retrospective cohort study using data from Kaiser Permanente Northern California’s electronic health system to compare health care use immediately after (within 24 hours of deliver placenta) and delayed (24 hours to 6 weeks later) IUD placement.
- They included 11,875 patients who delivered a newborn and had an IUD placed between 0 and 63 days after delivery from 2016 to 2020, of whom 1543 received an IUD immediately.
- The main outcome measures focused on the number of outpatient visits to the OB/GYN for any indication within 1 year after delivery.
- Secondary outcomes included pelvic or abdominal ultrasonograms performed in radiology departments, surgical procedures, hospitalizations related to IUD placement, and pregnancy rates during 1 year.
TAKE AWAY:
- Immediate IUD placement was associated with a modest reduction in the number of overall OB/GYN visits compared with delayed placement (mean visits, 2.30 vs 2.47; adjusted hazard ratio. [aRR]0.91; 95% CI, 0.87–0.94; Q <.001).
- Immediate IUD placement was associated with more imaging studies outside of the OB/GYN visit (aRR, 2.26; Q <.001); however, rates of laparoscopic surgery for IUD-related complications were lower in the immediate than in the delayed group (0.0% vs 0.4%; Q = .005).
- Hospitalizations related to IUD insertion were rare and increased in the immediate group (0.4% immediate; 0.02% delayed; Q <.001).
- No significant difference in repeat pregnancy was observed between groups at 1 year (Q = .342), and immediate IUD placement was not associated with an increased risk of ectopic pregnancy.
USE:
“Because one of the main goals of the rapid IUD is to prevent unplanned pregnancy in the short term, it is very important to emphasize that there was no difference between the study groups,” the authors wrote. “This research may guide patient counseling and approval of immediate IUD access,” they continued to add.
SOURCE:
The study was led by Talis M. Swisher, MD, of the Department of Obstetrics and Gynecology at Kaiser Permanente San Leandro Medical Center in San Leandro, California. Published online on December 12, 2024, by Obstetrics and Gynecology.
ACTIONS:
Data on patient satisfaction were not included in this study. No cost-benefit analysis was performed due to difficulties in comparing differences in insurance plans and regional differences in costs across the United States. The study setting was unique to Kaiser Permanente Northern California, where all hospital patients had access to IUDs and multiple ultrasonography settings were readily available. Follow-up visits were not included in the analysis.
DISCLOSURE:
This study was supported by the Kaiser Permanente Northern California Graduate Medical Education Program, Kaiser Foundation Hospitals. The authors report no potential conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors have reviewed this content before publication.
#Early #Postpartum #IUD #Health #Benefits
