Evidence map›Paper›PMID 39966761›Full record

ArticleBMC public health2025

Pre-pregnancy intrauterine device use is associated with a reduced risk of subsequent preterm birth: a large population-based cohort study.

Xing Chen, Tao Wang, Yan Zhang, Zhengyuan Xie, Cai Kong, Bingxue Wu, Yuzhi Lan, Hanfeng Ye, Xiangjing Song, Zigao Zhao and 1 more

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Xing ChenNHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, School of Public Health, Fudan University, Shanghai, China.
Tao WangYunnan Population and Family Planning Research Institute, Kunming, China.
Yan ZhangNHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, School of Public Health, Fudan University, Shanghai, China.
Zhengyuan XieYunnan Population and Family Planning Research Institute, Kunming, China.
Cai KongYunnan Population and Family Planning Research Institute, Kunming, China.
Bingxue WuNHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, School of Public Health, Fudan University, Shanghai, China.
Yuzhi LanYunnan Population and Family Planning Research Institute, Kunming, China.
Hanfeng YeYunnan Population and Family Planning Research Institute, Kunming, China.
Xiangjing SongYunnan Population and Family Planning Research Institute, Kunming, China.
Zigao ZhaoYunnan Population and Family Planning Research Institute, Kunming, China. 921351623@qq.com.
Yan CheNHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, School of Public Health, Fudan University, Shanghai, China. cheyan2004@163.com.

Funding

Key Laboratory of Preconception Health in Western China/Key Laboratory of Fertility Regulation and Minority Birth Health Research of Yunnan Province ZDsys2021003Major Science and Technology Project of Yunnan (Biomedicine) 202002AA100007
6 · The paper itself

Abstract

backgroundThe effect of pre-pregnancy intrauterine device (IUD) use on subsequent preterm birth (PTB) remains unclear. We aim to investigate the association between IUD use before pregnancy and subsequent PTB.

methodsA total of 240,437 women who participated in the National Free Preconception Health Examination Project (NFPHEP) in Yunnan from 2013 to 2019 were included in the study. All study participants were classified into three groups according to their use of pre-pregnancy contraceptive methods: non-method users, IUD users, and other method users. We used a multivariable Poisson regression model to investigate the association between the use of an IUD before pregnancy and subsequent PTB. Further models analyzed the multiplicative and additive interactions between pre-pregnancy IUD use and county deprivation.

resultsOf all the participants, 45,374 (18.9%) used IUDs before pregnancy, 39,414 (16.4%) used other contraceptive methods, and 155,649 (64.7%) were non-method users. The overall PTB rate was 5.30% (95% confidence interval [95% CI], 5.20-5.38%), and women in the IUD group had a significantly lower PTB rate (4.86%, 95% CI 4.66-5.06%) than women in the non-method (5.42%, 95% CI 5.31-5.53%) and other method groups (5.33%, 95% CI 5.11-5.56%). IUD use before pregnancy was associated with a reduced risk of subsequent PTB (model 1: adjusted relative risk [aRR] 0.84, 95% CI 0.80 to 0.89; model 2: aRR 0.84, 95% CI 0.79 to 0.90). In counties with a normal level of development, IUD users had a 30% lower risk of subsequent PTB than non-users (aRR 0.70, 95% CI 0.63 to 0.78). Compared with non-IUD users (incuding non-method and other method users) from the least developed counties, those from counties with a normal level of socioeconomic development had the lowest risk of subsequent PTB (aRR 0.71, 0.62 to 0.82). The additive interaction between pre-pregnancy IUD use and low level of county development was statistically significant (relative excess risk due to interaction [RERI] -0.27, -0.41 to -0.14).

conclusionPre-pregnancy IUD use is associated with a reduced risk of subsequent PTB. Pre-pregnancy IUD users in counties with a normal level of development were associated with a lower risk of subsequent PTB than their counterparts in the least developed countries.

Indexed as

Intrauterine DevicesPremature BirthAdultChinaCohort StudiesFemaleHumansPregnancyRisk FactorsYoung AdultContraceptionInteractionIntrauterine devicesPre-pregnancy examinationPreterm birth

Identifiers

PMID39966761
PMCPMC11837476

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.