ASSOCIATION BETWEEN INTRAUTERINE-DEVICE AND PELVIC INFLAMMATORY DISEASE

Abstract

The Women''s Health Study, a concurrent case-control study at 16 hospitals in 9 cities across the USA, examined the relationship between use of an intrauterine contraceptive device (IUD) and pelvic inflammatory disease (PID) severe enough to require hospitalization. After final classification, 1447 patients were eligible as PID subjects and 3453 patients were eligible as controls. For all current IUD users, the estimated relative risk of hospitalization with PID diagnosis was 1.6. The relative risk was about 2-fold when only individuals experiencing their 1st disorder episode were considered. The study also demonstrated an increased association for women aged 25 yr or less and for nonblack women. Recent insertion or reinsertion of an IUD was associated with increased PID risk, but total use duration was not. The IUD use effect on PID development persisted for several mo. after the IUD was removed. The study also confirmed previous findings that the device type does not markedly influence risk, and that the relative PID risk is higher when IUD use is compared with use of other contraceptives or use of no contraceptives. Apparently users of nonpermanent contraception forms other than the IUD have some form of protection against PID development.