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Experience with intrauterine device insertion in never sexually active adolescents: a retrospective cohort study.
Am J Obstet Gynecol 2018; 219(6):600.e1-600.e7AJ

Abstract

BACKGROUND

Intrauterine devices can offer both contraceptive and noncontraceptive benefits to never sexually active adolescents. There are increasing data on intrauterine device use in adolescents; however, most data on intrauterine devices in adolescents are related to contraceptive use. There is very limited literature on intrauterine device placement in adolescents who have never been sexually active.

OBJECTIVE

The objective of the study was to compare intrauterine device insertion success between never sexually active and sexually active cohorts.

STUDY DESIGN

We performed a retrospective chart review of patients aged 10-20 years with attempted intrauterine device insertion at a children's hospital between October 2015 and September 2017.

RESULTS

A total of 210 patients were included, of whom 82 were never sexually active. Never sexually active adolescents were younger at insertion (15.6 vs 16.7 years, P < .001), more likely to have at least 1 medical problem (75.6% vs 54.7%, P = .046), and to have special needs (23.2% vs 4.7%, P < .001). Never sexually active adolescents were less likely to have intrauterine device insertion performed in the office setting (52.4% vs 94.5%, P < .001). There was no significant difference in success of intrauterine device insertion on the first attempt (90.2% vs 96.1%, P = .086). In a subanalysis of office insertions alone, never sexually active adolescents were more likely to have an unsuccessful intrauterine device insertion (16.3% vs 4.3%, P = .015) and less likely to tolerate the procedure well (81.4% vs 94.2%, P = .026).

CONCLUSION

To our knowledge, this is the first study describing intrauterine device insertion in never sexually active patients. Although office success rates were lower, intrauterine device insertion in never sexually active adolescents was very successful overall, and intrauterine devices should be offered to this population.

Authors+Show Affiliations

Nemours/A. I. duPont Hospital for Children, Wilmington, DE; Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, DE. Electronic address: chelsea.a.kebodeaux@christianacare.org.Nemours/A. I. duPont Hospital for Children, Wilmington, DE; Division of Adolescent Medicine and Pediatric Gynecology, Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; Department of Obstetrics and Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30278178

Citation

Kebodeaux, Chelsea A., and Beth I. Schwartz. "Experience With Intrauterine Device Insertion in Never Sexually Active Adolescents: a Retrospective Cohort Study." American Journal of Obstetrics and Gynecology, vol. 219, no. 6, 2018, pp. 600.e1-600.e7.
Kebodeaux CA, Schwartz BI. Experience with intrauterine device insertion in never sexually active adolescents: a retrospective cohort study. Am J Obstet Gynecol. 2018;219(6):600.e1-600.e7.
Kebodeaux, C. A., & Schwartz, B. I. (2018). Experience with intrauterine device insertion in never sexually active adolescents: a retrospective cohort study. American Journal of Obstetrics and Gynecology, 219(6), pp. 600.e1-600.e7. doi:10.1016/j.ajog.2018.09.033.
Kebodeaux CA, Schwartz BI. Experience With Intrauterine Device Insertion in Never Sexually Active Adolescents: a Retrospective Cohort Study. Am J Obstet Gynecol. 2018;219(6):600.e1-600.e7. PubMed PMID: 30278178.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Experience with intrauterine device insertion in never sexually active adolescents: a retrospective cohort study. AU - Kebodeaux,Chelsea A, AU - Schwartz,Beth I, Y1 - 2018/09/29/ PY - 2018/05/24/received PY - 2018/08/25/revised PY - 2018/09/24/accepted PY - 2018/10/3/pubmed PY - 2018/10/3/medline PY - 2018/10/3/entrez KW - adolescent KW - contraception KW - intrauterine device KW - never sexually active KW - nulliparous KW - virginal SP - 600.e1 EP - 600.e7 JF - American journal of obstetrics and gynecology JO - Am. J. Obstet. Gynecol. VL - 219 IS - 6 N2 - BACKGROUND: Intrauterine devices can offer both contraceptive and noncontraceptive benefits to never sexually active adolescents. There are increasing data on intrauterine device use in adolescents; however, most data on intrauterine devices in adolescents are related to contraceptive use. There is very limited literature on intrauterine device placement in adolescents who have never been sexually active. OBJECTIVE: The objective of the study was to compare intrauterine device insertion success between never sexually active and sexually active cohorts. STUDY DESIGN: We performed a retrospective chart review of patients aged 10-20 years with attempted intrauterine device insertion at a children's hospital between October 2015 and September 2017. RESULTS: A total of 210 patients were included, of whom 82 were never sexually active. Never sexually active adolescents were younger at insertion (15.6 vs 16.7 years, P < .001), more likely to have at least 1 medical problem (75.6% vs 54.7%, P = .046), and to have special needs (23.2% vs 4.7%, P < .001). Never sexually active adolescents were less likely to have intrauterine device insertion performed in the office setting (52.4% vs 94.5%, P < .001). There was no significant difference in success of intrauterine device insertion on the first attempt (90.2% vs 96.1%, P = .086). In a subanalysis of office insertions alone, never sexually active adolescents were more likely to have an unsuccessful intrauterine device insertion (16.3% vs 4.3%, P = .015) and less likely to tolerate the procedure well (81.4% vs 94.2%, P = .026). CONCLUSION: To our knowledge, this is the first study describing intrauterine device insertion in never sexually active patients. Although office success rates were lower, intrauterine device insertion in never sexually active adolescents was very successful overall, and intrauterine devices should be offered to this population. SN - 1097-6868 UR - https://www.unboundmedicine.com/medline/citation/30278178/Experience_with_intrauterine_device_insertion_in_never_sexually_active_adolescents:_a_retrospective_cohort_study L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(18)30825-1 DB - PRIME DP - Unbound Medicine ER -