The safety of intrauterine devices in breastfeeding women: a systematic review

Erin N Berry-Bibee; Naomi K Tepper; Tara C Jatlaoui; Maura K Whiteman; Denise J Jamieson; Kathryn M Curtis

doi:10.1016/j.contraception.2016.07.006

Back

The safety of intrauterine devices in breastfeeding women: a systematic review

Journal article

Open access

Peer reviewed

The safety of intrauterine devices in breastfeeding women: a systematic review

Erin N Berry-Bibee, Naomi K Tepper, Tara C Jatlaoui, Maura K Whiteman, Denise J Jamieson and Kathryn M Curtis

Contraception (Stoneham), Vol.94(6), pp.725-738

12/01/2016

DOI: 10.1016/j.contraception.2016.07.006

PMCID: PMC11283814

PMID: 27421765

Files and links (1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/11283814View

Open Access

Abstract

To investigate levonorgestrel (LNG)-releasing and copper-bearing (Cu) intrauterine device (IUD) safety among breastfeeding women and, for Cu-IUD use, breastfeeding performance and infant health. Systematic review. We searched PubMed, Embase, Cochrane Library and clinicaltrials.gov for articles through January 2016. We included studies of Cu-IUD or LNG-IUD users comparing IUD-specific (perforation, expulsion) and other contraceptive-related (infection, removal/cessation due to bleeding/pain and other adverse events) outcomes for breastfeeding vs. non-breastfeeding women. We also included studies of breastfeeding women comparing contraceptive-related outcome for IUD-users vs. other contraceptive-method users. Finally, we included studies comparing breastfeeding outcomes among Cu-IUD users to users of other nonhormonal contraceptives or no contraception. Of 548 articles identified, 23 (16 studies) met the inclusion criteria. Two studies suggested that the risk of IUD perforation was 6-10 times higher among breastfeeding vs. non-breastfeeding women. Seven studies suggested that risks for other adverse events were similar or lower among breastfeeding vs. non-breastfeeding women. Three studies among breastfeeding women found no increased risk of adverse events in IUD users vs. nonusers. Breastfeeding performance and infant growth were similar for Cu-IUD users and users of other nonhormonal methods or no contraception. Overall, risks for adverse events among IUD users, including expulsion, pain and removals, were similar or lower for breastfeeding women vs. non-breastfeeding women. Uterine perforation with IUDs, while rare, appeared more frequent among breastfeeding women. No evidence indicated that Cu-IUD use in breastfeeding women influences breastfeeding performance or infant growth.

Breast Feeding

Contraception - methods

Contraceptive Agents, Female - administration & dosage

Equipment Safety

Female

Humans

Intrauterine Devices, Copper - adverse effects

Levonorgestrel - administration & dosage

Postpartum Period

Randomized Controlled Trials as Topic

Risk Assessment

Uterine Perforation - etiology

Details

Title: Subtitle: The safety of intrauterine devices in breastfeeding women: a systematic review
Creators: Erin N Berry-Bibee - Centers for Disease Control and Prevention
Naomi K Tepper - Centers for Disease Control and Prevention
Tara C Jatlaoui - Centers for Disease Control and Prevention
Maura K Whiteman - Centers for Disease Control and Prevention
Denise J Jamieson - Centers for Disease Control and Prevention
Kathryn M Curtis - Centers for Disease Control and Prevention
Resource Type: Journal article
Publication Details: Contraception (Stoneham), Vol.94(6), pp.725-738
DOI: 10.1016/j.contraception.2016.07.006
PMID: 27421765
PMCID: PMC11283814
NLM abbreviation: Contraception
ISSN: 0010-7824
eISSN: 1879-0518
Language: English
Date published: 12/01/2016
Academic Unit: Obstetrics and Gynecology; VPMA - Administration
Record Identifier: 9984446514602771

Metrics

14 Record Views

32 Times Cited - Web of Science

See more details