Vos Annika A G, Veldhuis Hanna M, Lagro-Janssen Toine L M
Women's Studies in Medicine, Department of General Practice, University of Nijmegen, Nijmegen, The Netherlands.
Contraception. 2004 Apr;69(4):283-7. doi: 10.1016/j.contraception.2003.12.002.
The intrauterine device (IUD) use in the Netherlands and the United States is limited to a small group of women, though the risk of infection and pregnancy is small. Therefore, it was of interest to investigate the characteristics of women who choose an IUD as contraceptive method and the influence of general practitioners concerning IUD insertion. The aim of this retrospective cohort study was to assess differences between general practices and to investigate the characteristics of IUD users. Also, we wished to study changes in IUD use with time. Patients were selected from four academic general practices belonging to the continuous morbidity registration project in Nijmegen, the Netherlands. The population under study included 461 women registered in the academic practices with a code for insertion of a new IUD in the period from 1981 to 2001. More than half of the women were between 25 and 34 years old at the time of insertion. Almost one quarter were nulliparous, one quarter unmarried and the distribution of socioeconomic status was the same as the entire practice population. General practitioners have clear preferences for certain types of IUD and, in particular, for not inserting an IUD in nulliparous women. In conclusion, married or cohabiting women, around 30 years of age, with children, are in the majority in receiving an IUD as contraception. General practitioners clearly follow their own opinions about inserting IUD in nulliparous women. Currently, general practitioners are prescribing more Multiload Cu 375 IUDs and levonorgestrel-releasing IUDs.
在荷兰和美国，宫内节育器（IUD）的使用仅限于一小部分女性，尽管感染和怀孕的风险很小。因此，研究选择IUD作为避孕方法的女性的特征以及全科医生对IUD置入的影响很有意义。这项回顾性队列研究的目的是评估全科医疗之间的差异，并调查IUD使用者的特征。此外，我们还希望研究IUD使用随时间的变化。患者选自荷兰奈梅亨连续发病登记项目中的四个学术性全科医疗。研究人群包括1981年至2001年期间在学术性医疗中登记且有新IUD置入代码的461名女性。超过一半的女性在置入时年龄在25至34岁之间。近四分之一为未生育女性，四分之一未婚，社会经济地位分布与整个医疗人群相同。全科医生对某些类型的IUD有明确偏好，尤其是不向未生育女性置入IUD。总之，已婚或同居、年龄约30岁且有孩子的女性在接受IUD避孕的人群中占大多数。全科医生在未生育女性IUD置入方面明显遵循自己的意见。目前，全科医生正在开出更多的多负荷铜375 IUD和左炔诺孕酮释放IUD。
