Cates W, Ory H W, Rochat R W, Tyler C W
N Engl J Med. 1976 Nov 18;295(21):1155-9. doi: 10.1056/NEJM197611182952102.
To evaluate the intrauterine device as a risk factor for mortality associated with spontaneous abortion, we analyzed all deaths from spontaneous abortions reported in the period 1972-1974. Women dying from spontaneous abortions with a device in place were more likely to be young, white and married than those not wearing a device. Risk of death from spontaneous abortion was over 50 times greater for women who continued their pregnancy with a device in place than for those who did not. The Dalkon shield carried an increased risk of death, as compared to other devices, even after rates were adjusted for duration of use. However, pregnant women with either a loop or a coil in place also had a higher risk of dying from spontaneous abortion than those without any device. The results support the clinical recommendation that any device should be removed when pregnancy is first diagnosed.
为评估宫内节育器作为自然流产相关死亡的危险因素,我们分析了1972年至1974年期间报告的所有自然流产死亡病例。与未佩戴宫内节育器的女性相比,佩戴宫内节育器死于自然流产的女性更可能年轻、为白人且已婚。继续妊娠且佩戴宫内节育器的女性自然流产死亡风险比未佩戴者高出50倍以上。与其他节育器相比,即使对使用时长进行了比率调整,达康盾仍有更高的死亡风险。然而,佩戴环形或螺旋形节育器的孕妇自然流产死亡风险也高于未使用任何节育器的孕妇。这些结果支持了一项临床建议,即一旦确诊怀孕,应取出任何节育器。