Effects of age, parity, and device type on complications and discontinuation of intrauterine devices

摘要

To the Editor: The retrospective chart review by Aoun et al analyzed intrauterine device (IUD)-related outcomes by age, parity, and IUD type. One of the authors' main conclusions was that teenagers and young women may benefit from additional counseling because they are more likely to request removal before product expiration. The authors identify in the Discussion that the primary causes of early removal are pain and bleeding. However, the data and available literature do not support this conclusion. First, although univariate analysis does show a significant difference in discontinuation rates for pain and abnormal bleeding, only pain appears to be related to age. The percentage of young (aged 13-19 years) females that discontinued because of abnormal bleeding was lower than women aged 25-35 years. More importantly, although the study methods include a description of a multivar-iable analysis, none is presented in the results. In this type of study, only with multivariable analysis can this univariate finding be validated.