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The following is a summary of “Health Care Utilization After Immediate Compared With Delayed Postpartum Intrauterine Device Placement,” published in the December 2024 issue of Obstetrics and Gynecology by Swisher et al.
The timing of postpartum intrauterine device (IUD) placement can affect healthcare utilization and complication rates among individuals who give birth.
Researchers conducted a retrospective study to compare how often patients used health care services when an IUD was placed right after giving birth vs. placed later.
They analyzed data from Kaiser Permanente Northern California (2017–2019) on individuals with IUD placement between 0 and 63 days postpartum. The primary outcome was the number of obstetricians–gynecologist (OB-GYN) or women’s health office visits within 1 year. Secondary outcomes included formal imaging studies, surgical interventions, hospitalizations for IUD-related complications, and live births at 120 days and 1 year.
The results showed that individuals with delayed IUD placement had a slightly higher number of OB-GYN or women’s health office visits (mean 2.30 vs 2.47, P<.001). Imaging use was more common in the immediate placement group (10.5% vs 4.1%, P<.001). Laparoscopic surgeries were fewer in the immediate group (0.0% vs 0.4%, P=.005), while hysteroscopy rates were similar between groups (0.2% vs 0.1%, P=.413). Hospitalizations were rare but occurred more frequently in the immediate group (0.4% vs 0.02%, P<.001). Repeat pregnancy rates at 120 days (0.2%) and 1 year (2.9% vs 2.5%, P=.342) were not significantly different between groups.
They concluded that immediate postpartum IUD placement increased imaging use but reduced the need for laparoscopic surgery, with no significant differences in-office visits or live birth rates compared to delayed placement.
