The safety of intrauterine devices in breastfeeding women: a systematic review ☆,☆☆,★

Details

• Alternative Title:
  Contraception
• Personal Author:
  Berry-Bibee, Erin N. ; Tepper, Naomi K. ; Jatlaoui, Tara C. ; Whiteman, Maura K. ; Jamieson, Denise J. ; Curtis, Kathryn M.
• Description:
  Objectives:
  
  To investigate levonorgestrel (LNG)-releasing and copper-bearing (Cu) intrauterine device (IUD) safety among breastfeeding women and, for Cu-IUD use, breastfeeding performance and infant health.
  
  Study design:
  
  Systematic review.
  
  Methods:
  
  We searched PubMed, Embase, Cochrane Library and clinicaltrials.gov for articles through January 2016. We included studies of Cu-IUD or LNG-IUD users comparing IUD-specific (perforation, expulsion) and other contraceptive-related (infection, removal/cessation due to bleeding/pain and other adverse events) outcomes for breastfeeding vs. non-breastfeeding women. We also included studies of breastfeeding women comparing contraceptive-related outcome for IUD-users vs. other contraceptive-method users. Finally, we included studies comparing breastfeeding outcomes among Cu-IUD users to users of other nonhormonal contraceptives or no contraception.
  
  Results:
  
  Of 548 articles identified, 23 (16 studies) met the inclusion criteria. Two studies suggested that the risk of IUD perforation was 6–10 times higher among breastfeeding vs. non-breastfeeding women. Seven studies suggested that risks for other adverse events were similar or lower among breastfeeding vs. non-breastfeeding women. Three studies among breastfeeding women found no increased risk of adverse events in IUD users vs. nonusers. Breastfeeding performance and infant growth were similar for Cu-IUD users and users of other nonhormonal methods or no contraception.
  
  Conclusion:
  
  Overall, risks for adverse events among IUD users, including expulsion, pain and removals, were similar or lower for breastfeeding women vs. non-breastfeeding women. Uterine perforation with IUDs, while rare, appeared more frequent among breastfeeding women. No evidence indicated that Cu-IUD use in breastfeeding women influences breastfeeding performance or infant growth.
  
  
• Subjects:
  Breast Feeding Contraception Contraceptive Agents, Female Equipment Safety Female Humans Intrauterine Devices, Copper Levonorgestrel Postpartum Period Randomized Controlled Trials As Topic Risk Assessment Uterine Perforation

  More +
• Keywords:
  Breastfeeding Intrauterine Device IUD Uterine Perforation
• Source:
  Contraception. 94(6):725-738
• Pubmed ID:
  27421765
• Pubmed Central ID:
  PMC11283814
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  94
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:b405d1f093731d481e3e0a17f77b965c5c43b349e467d870df8245209c53ae2cde323f88ce185ac76002dc4994f0146d783d5a2d9db6d5361142767e6301c649
• Download URL:
  https://stacks.cdc.gov/view/cdc/159442/cdc_159442_DS1.pdf
• File Type:
  [PDF - 422.86 KB ]