Khader Yousef S, El-Qaderi Saleh, Khader Ali Mohammad
Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
J Fam Plann Reprod Health Care. 2006 Jul;32(3):161-4. doi: 10.1783/147118906777888279.
To determine the intrauterine contraceptive device (IUD) discontinuation rate and its causes and related factors among women attending UNRWA health centres in Jordan.
The study cohort comprised 371 women who had an IUD inserted during 1997 and who were interviewed during their visits to the health centres in the period January-March 2003. The main outcome measure was IUD discontinuation.
The incidence of IUD discontinuation in the first year following insertion was 17.5%. Approximately 32% of the study sample continued using their devices after 5 years. The average duration of IUD use was 36 months. Of the 371 women, 39.6% discontinued IUD use because of a desire to conceive, 18.6% because of side effects, 4.9% because they were sexually inactive and 1.6% because of opposition from the woman's family. The most common side effects reported as reasons for discontinuation were bleeding, infection and pain. Discontinuation was inversely related to current age, marital age and number of living children. Outside camp residents, previous contraceptive users and women with obstetric complications were significantly less likely to discontinue IUD use.
The crude cumulative rate of IUD discontinuation was 17.5% during the first year, suggesting a need to tackle the problem of discontinuation through effective educational strategies on the process of fertility and contraception. The most common reason for voluntary IUD removal was the women's desire to conceive. This suggests that improved counselling and good selection of candidates before IUD insertion is required.
确定约旦近东救济工程处保健中心就诊女性的宫内节育器（IUD）停用率及其原因和相关因素。
研究队列包括1997年放置IUD且在2003年1月至3月期间到保健中心就诊时接受访谈的371名女性。主要观察指标是IUD停用情况。
放置后第一年IUD停用率为17.5%。约32%的研究样本在5年后仍继续使用其IUD。IUD使用的平均持续时间为36个月。在371名女性中，39.6%因希望怀孕而停用IUD，18.6%因副作用停用，4.9%因性生活不活跃停用，1.6%因女性家人反对停用。报告作为停用原因的最常见副作用是出血、感染和疼痛。停用与当前年龄、结婚年龄和存活子女数呈负相关。营地外居民、既往使用过避孕药具者和有产科并发症的女性停用IUD的可能性显著较低。
第一年IUD停用的粗略累积率为17.5%，这表明需要通过关于生育和避孕过程的有效教育策略来解决停用问题。自愿取出IUD的最常见原因是女性希望怀孕。这表明在放置IUD之前需要改善咨询并更好地筛选候选人。
