Elevated Risk of Bacterial Vaginosis Among Users of the Copper Intrauterine Device: A Prospective Longitudinal Cohort Study.
Clin Infect Dis
; 73(3): 513-520, 2021 08 02.
Article
en En
| MEDLINE
| ID: mdl-32505132
ABSTRACT
BACKGROUND:
Limited evidence suggests that the nonhormonal contraceptive copper intrauterine device (Cu-IUD) may increase bacterial vaginosis (BV) risk, possibly due to increased volume and duration of menses, a common side effect of Cu-IUD use. Although increases in bleeding typically resolve within 6-12 months following initiation, evaluations of the association between Cu-IUD and BV have not included more than 6 months of follow-up.METHODS:
This secondary analysis of a human immunodeficiency virus type 1 prevention trial included 2585 African women ages 18-45 followed for up to 33 months. Women reported contraceptive use each month. BV was evaluated by Nugent score in 6-monthly intervals and, if clinically indicated, by Amsel criteria. Andersen-Gill proportional hazards models were used to (1) evaluate BV risk among Cu-IUD users relative to women using no/another nonhormonal contraceptive and (2) test changes in BV frequency before, while using, and following Cu-IUD discontinuation.RESULTS:
BV frequency was highest among Cu-IUD users at 153.6 episodes per 100 person-years (95% confidence interval [CI] 145.2, 162.4). In adjusted models, Cu-IUD users experienced 1.28-fold (95% CI 1.12, 1.46) higher BV risk relative to women using no/another nonhormonal contraception. Compared to the 6 months prior to initiation, BV risk was 1.52-fold (95% CI 1.16, 2.00) higher in the first 6 months of Cu-IUD use and remained elevated over 18 months of use (Pâ <â .05). Among women who discontinued Cu-IUD, BV frequency was similar to pre-initiation rates within 1 year.CONCLUSIONS:
Cu-IUD users experienced elevated BV risk that persisted throughout use. Women and their providers may wish to consider BV risk when discussing contraceptive options.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Vaginosis Bacteriana
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Dispositivos Intrauterinos de Cobre
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Clin Infect Dis
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos