Evidence map›Paper›PMID 36427600›Full record

Trial reportAmerican journal of obstetrics and gynecology2023

One-year pregnancy and continuation rates after placement of levonorgestrel or copper intrauterine devices for emergency contraception: a randomized controlled trial.

Jennifer E Kaiser, David K Turok, Alexandra Gero, Lori M Gawron, Rebecca G Simmons, Jessica N Sanders

Open access · greenAbstract readRandomized Controlled TrialEquivalence Trial
In one paragraph

Trial report in American journal of obstetrics and gynecology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Jennifer E KaiserDivision of Family Planning, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT. Electronic address: Jennifer.Kaiser@hsc.utah.edu.
David K TurokDivision of Family Planning, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT.
Alexandra GeroDivision of Family Planning, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT.
Lori M GawronDivision of Family Planning, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT.
Rebecca G SimmonsDivision of Family Planning, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT.
Jessica N SandersDivision of Family Planning, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT.
University of Utah · US

Funding

Utah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0M
University of Utah Center for Clinical and Translational ScienceUL1TR001067 · NCATS · UNIVERSITY OF UTAH · PI DERE, WILLARD H., HESS, RACHEL · 2013 to 2017
$19.8M
UNIVERSITY OF UTAH CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCE-UL1: BPCAUL1RR025764 · NCRR · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2008 to 2011
$19.4M
University of Utah Center for Clinical and Translational Science-UL1UL1TR000105 · NCATS · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2012 to 2013
$5.1M
RCT Assessing Pregnancy with Intrauterine Devices for Emergency ContraceptionR01HD083340 · NICHD · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI David Turok · 2015 to 2026
$3.6M
Midcareer Investigator Award in Patient-Oriented Research K24K24HD087436 · NICHD · UNIVERSITY OF UTAH · PI TUROK, DAVID · 2017 to 2021
$942k
Leveraging Linked Data to Evaluate Social and Spatial Disparities in Contraception Access and Regional Program ImpactsK01HS027220 · AHRQ · UNIVERSITY OF UTAH · PI SANDERS, JESSICA N · 2020 to 2022
$471k
AHRQ HHS K01 HS027220NCATS NIH HHS UL1 TR000105NCATS NIH HHS UL1 TR001067NCATS NIH HHS UL1 TR002538NCRR NIH HHS UL1 RR025764NICHD NIH HHS K24 HD087436NICHD NIH HHS R01 HD083340
6 · The paper itself

Abstract

backgroundRecent evidence demonstrates the effectiveness of the levonorgestrel 52-mg intrauterine device for emergency contraception vs the copper T380A intrauterine device. Of note, 1-year pregnancy and continuation rates after intrauterine device placement for emergency contraception remain understudied.

objectiveThis study compared 1-year pregnancy and intrauterine device continuation rates and reasons for discontinuation among emergency contraception users randomized to the levonorgestrel 52-mg intrauterine device or the copper intrauterine device. STUDY

designThis participant-masked, randomized noninferiority trial recruited emergency contraception individuals desiring an intrauterine device from 6 Utah family planning clinics between August 2016 and December 2019. Participants were randomized 1:1 to the levonorgestrel 52-mg intrauterine device group or the copper T380A intrauterine device group. Treatment allocation was revealed to participants at the 1-month follow-up. Trained personnel followed up the participants by phone, text, or e-mail at 5 time points in 1 year and reviewed electronic health records for pregnancy and intrauterine device continuation outcomes for both confirmation and nonresponders. We assessed the reasons for the discontinuation and used Cox proportional-hazard models, Kaplan-Meier estimates, and log-rank tests to assess differences in the continuation and pregnancy rates between the groups.

resultsThe levonorgestrel and copper intrauterine device groups included 327 and 328 participants, respectively, receiving the respective interventions. By intention-to-treat analysis at 1 year, the pregnancy rates were similar between intrauterine device types (2.8% [9/327] in levonorgestrel 52-mg intrauterine device vs 3.0% [10/328] in copper intrauterine device; risk ratio, 0.9; 95% confidence interval, 0.4-2.2; P=.82). Most pregnancies occurred in participants after intrauterine device removal, with only 1 device failure in each group. Of note, 1-year continuation rates did not differ between groups with 204 of 327 levonorgestrel 52-mg intrauterine device users (62.4%) and 183 of 328 copper T380A intrauterine device users (55.8%) continuing intrauterine device use at 1 year (risk ratio, 1.1; 95% confidence interval, 1.0-1.2; P=.09). There were differences concerning the reasons for discontinuation between intrauterine device types, with more bleeding and cramping cited among copper intrauterine device users.

conclusionThe pregnancy rates were low and similar between intrauterine device types. Of note, 6 of 10 intrauterine device emergency contraception users continued use at 1 year. Moreover, 1-year continuation rates were similar between intrauterine device types.

Indexed as

Contraception, PostcoitalContraceptive Agents, FemaleIntrauterine DevicesIntrauterine Devices, CopperIntrauterine Devices, MedicatedFemaleHumansLevonorgestrelPregnancyUtahContraceptive Agents, FemaleLevonorgestrelemergency contraceptionintrauterine device

Identifiers

PMID36427600
PMCPMC10065890
OpenAlexW4309724309

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.