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Abstract
Discussion Forum (0)
Introduction:
We aimed to identify the risk factors for intrauterine device (IUD) malposition and to develop a model to predict who is at risk for IUD malposition.
Methods:
We performed a retrospective cohort study of IUD users with ultrasounds performed between July 2014 to July 2017 within a large, urban, academic medical system. Our primary outcome was IUD malposition. Fisher's Exact Test and Wilcoxon Rank Sum test we used. We used logistic regression, least absolute shrinkage and selection operator (LASSO), and elastic net models to pred predict the likelihood of having a malpositioned IUD. IRB approval was obtained.
Results:
Of 1,759 ultrasound reports with an IUD present, 436 described a malpositioned IUD. Compared to participants with non-malpositioned IUDs, participants with malpositioned IUDs were more likely to be younger (30.7 and 31.9 years old, p=0.02), have fibroids (21.6% and 15.9%, p < 0.01), and have abnormal uterine bleeding (AUB) (19.7% and 14.9%, p=0.02). There were no differences between groups in gravidity, parity, uterine surgeries, number of cesarean deliveries, IUD type, or timing of IUD placement relative to abortion or delivery. Reports describing malpositioned IUDs were more likely to have been authored by radiologists than gynecologists (85.1% and 13.5%, p < 0.01). LASSO model, elastic net model, and logistic regression were unable to identify a meaningfully predictive model for IUD malpositionConclusion/Implications: Fibroids and AUB are associated with IUD malposition. No other risk factors were statistically or clinically significant. No linear combination of factors meaningfully predicted risk of IUD malposition. Radiologists were more likely to author reports describing malpositioned IUDs.
We aimed to identify the risk factors for intrauterine device (IUD) malposition and to develop a model to predict who is at risk for IUD malposition.
Methods:
We performed a retrospective cohort study of IUD users with ultrasounds performed between July 2014 to July 2017 within a large, urban, academic medical system. Our primary outcome was IUD malposition. Fisher's Exact Test and Wilcoxon Rank Sum test we used. We used logistic regression, least absolute shrinkage and selection operator (LASSO), and elastic net models to pred predict the likelihood of having a malpositioned IUD. IRB approval was obtained.
Results:
Of 1,759 ultrasound reports with an IUD present, 436 described a malpositioned IUD. Compared to participants with non-malpositioned IUDs, participants with malpositioned IUDs were more likely to be younger (30.7 and 31.9 years old, p=0.02), have fibroids (21.6% and 15.9%, p < 0.01), and have abnormal uterine bleeding (AUB) (19.7% and 14.9%, p=0.02). There were no differences between groups in gravidity, parity, uterine surgeries, number of cesarean deliveries, IUD type, or timing of IUD placement relative to abortion or delivery. Reports describing malpositioned IUDs were more likely to have been authored by radiologists than gynecologists (85.1% and 13.5%, p < 0.01). LASSO model, elastic net model, and logistic regression were unable to identify a meaningfully predictive model for IUD malpositionConclusion/Implications: Fibroids and AUB are associated with IUD malposition. No other risk factors were statistically or clinically significant. No linear combination of factors meaningfully predicted risk of IUD malposition. Radiologists were more likely to author reports describing malpositioned IUDs.
Introduction:
We aimed to identify the risk factors for intrauterine device (IUD) malposition and to develop a model to predict who is at risk for IUD malposition.
Methods:
We performed a retrospective cohort study of IUD users with ultrasounds performed between July 2014 to July 2017 within a large, urban, academic medical system. Our primary outcome was IUD malposition. Fisher's Exact Test and Wilcoxon Rank Sum test we used. We used logistic regression, least absolute shrinkage and selection operator (LASSO), and elastic net models to pred predict the likelihood of having a malpositioned IUD. IRB approval was obtained.
Results:
Of 1,759 ultrasound reports with an IUD present, 436 described a malpositioned IUD. Compared to participants with non-malpositioned IUDs, participants with malpositioned IUDs were more likely to be younger (30.7 and 31.9 years old, p=0.02), have fibroids (21.6% and 15.9%, p < 0.01), and have abnormal uterine bleeding (AUB) (19.7% and 14.9%, p=0.02). There were no differences between groups in gravidity, parity, uterine surgeries, number of cesarean deliveries, IUD type, or timing of IUD placement relative to abortion or delivery. Reports describing malpositioned IUDs were more likely to have been authored by radiologists than gynecologists (85.1% and 13.5%, p < 0.01). LASSO model, elastic net model, and logistic regression were unable to identify a meaningfully predictive model for IUD malpositionConclusion/Implications: Fibroids and AUB are associated with IUD malposition. No other risk factors were statistically or clinically significant. No linear combination of factors meaningfully predicted risk of IUD malposition. Radiologists were more likely to author reports describing malpositioned IUDs.
We aimed to identify the risk factors for intrauterine device (IUD) malposition and to develop a model to predict who is at risk for IUD malposition.
Methods:
We performed a retrospective cohort study of IUD users with ultrasounds performed between July 2014 to July 2017 within a large, urban, academic medical system. Our primary outcome was IUD malposition. Fisher's Exact Test and Wilcoxon Rank Sum test we used. We used logistic regression, least absolute shrinkage and selection operator (LASSO), and elastic net models to pred predict the likelihood of having a malpositioned IUD. IRB approval was obtained.
Results:
Of 1,759 ultrasound reports with an IUD present, 436 described a malpositioned IUD. Compared to participants with non-malpositioned IUDs, participants with malpositioned IUDs were more likely to be younger (30.7 and 31.9 years old, p=0.02), have fibroids (21.6% and 15.9%, p < 0.01), and have abnormal uterine bleeding (AUB) (19.7% and 14.9%, p=0.02). There were no differences between groups in gravidity, parity, uterine surgeries, number of cesarean deliveries, IUD type, or timing of IUD placement relative to abortion or delivery. Reports describing malpositioned IUDs were more likely to have been authored by radiologists than gynecologists (85.1% and 13.5%, p < 0.01). LASSO model, elastic net model, and logistic regression were unable to identify a meaningfully predictive model for IUD malpositionConclusion/Implications: Fibroids and AUB are associated with IUD malposition. No other risk factors were statistically or clinically significant. No linear combination of factors meaningfully predicted risk of IUD malposition. Radiologists were more likely to author reports describing malpositioned IUDs.
Risk Factors for IUD Malposition
Dr. Ann Frisse
Affiliations:
Icahn School of Medicine at Mount Sinai
Icahn School of Medicine at Mount Sinai
Abstract
Discussion Forum (0)
Introduction:
We aimed to identify the risk factors for intrauterine device (IUD) malposition and to develop a model to predict who is at risk for IUD malposition.
Methods:
We performed a retrospective cohort study of IUD users with ultrasounds performed between July 2014 to July 2017 within a large, urban, academic medical system. Our primary outcome was IUD malposition. Fisher's Exact Test and Wilcoxon Rank Sum test we used. We used logistic regression, least absolute shrinkage and selection operator (LASSO), and elastic net models to pred predict the likelihood of having a malpositioned IUD. IRB approval was obtained.
Results:
Of 1,759 ultrasound reports with an IUD present, 436 described a malpositioned IUD. Compared to participants with non-malpositioned IUDs, participants with malpositioned IUDs were more likely to be younger (30.7 and 31.9 years old, p=0.02), have fibroids (21.6% and 15.9%, p < 0.01), and have abnormal uterine bleeding (AUB) (19.7% and 14.9%, p=0.02). There were no differences between groups in gravidity, parity, uterine surgeries, number of cesarean deliveries, IUD type, or timing of IUD placement relative to abortion or delivery. Reports describing malpositioned IUDs were more likely to have been authored by radiologists than gynecologists (85.1% and 13.5%, p < 0.01). LASSO model, elastic net model, and logistic regression were unable to identify a meaningfully predictive model for IUD malpositionConclusion/Implications: Fibroids and AUB are associated with IUD malposition. No other risk factors were statistically or clinically significant. No linear combination of factors meaningfully predicted risk of IUD malposition. Radiologists were more likely to author reports describing malpositioned IUDs.
We aimed to identify the risk factors for intrauterine device (IUD) malposition and to develop a model to predict who is at risk for IUD malposition.
Methods:
We performed a retrospective cohort study of IUD users with ultrasounds performed between July 2014 to July 2017 within a large, urban, academic medical system. Our primary outcome was IUD malposition. Fisher's Exact Test and Wilcoxon Rank Sum test we used. We used logistic regression, least absolute shrinkage and selection operator (LASSO), and elastic net models to pred predict the likelihood of having a malpositioned IUD. IRB approval was obtained.
Results:
Of 1,759 ultrasound reports with an IUD present, 436 described a malpositioned IUD. Compared to participants with non-malpositioned IUDs, participants with malpositioned IUDs were more likely to be younger (30.7 and 31.9 years old, p=0.02), have fibroids (21.6% and 15.9%, p < 0.01), and have abnormal uterine bleeding (AUB) (19.7% and 14.9%, p=0.02). There were no differences between groups in gravidity, parity, uterine surgeries, number of cesarean deliveries, IUD type, or timing of IUD placement relative to abortion or delivery. Reports describing malpositioned IUDs were more likely to have been authored by radiologists than gynecologists (85.1% and 13.5%, p < 0.01). LASSO model, elastic net model, and logistic regression were unable to identify a meaningfully predictive model for IUD malpositionConclusion/Implications: Fibroids and AUB are associated with IUD malposition. No other risk factors were statistically or clinically significant. No linear combination of factors meaningfully predicted risk of IUD malposition. Radiologists were more likely to author reports describing malpositioned IUDs.
Introduction:
We aimed to identify the risk factors for intrauterine device (IUD) malposition and to develop a model to predict who is at risk for IUD malposition.
Methods:
We performed a retrospective cohort study of IUD users with ultrasounds performed between July 2014 to July 2017 within a large, urban, academic medical system. Our primary outcome was IUD malposition. Fisher's Exact Test and Wilcoxon Rank Sum test we used. We used logistic regression, least absolute shrinkage and selection operator (LASSO), and elastic net models to pred predict the likelihood of having a malpositioned IUD. IRB approval was obtained.
Results:
Of 1,759 ultrasound reports with an IUD present, 436 described a malpositioned IUD. Compared to participants with non-malpositioned IUDs, participants with malpositioned IUDs were more likely to be younger (30.7 and 31.9 years old, p=0.02), have fibroids (21.6% and 15.9%, p < 0.01), and have abnormal uterine bleeding (AUB) (19.7% and 14.9%, p=0.02). There were no differences between groups in gravidity, parity, uterine surgeries, number of cesarean deliveries, IUD type, or timing of IUD placement relative to abortion or delivery. Reports describing malpositioned IUDs were more likely to have been authored by radiologists than gynecologists (85.1% and 13.5%, p < 0.01). LASSO model, elastic net model, and logistic regression were unable to identify a meaningfully predictive model for IUD malpositionConclusion/Implications: Fibroids and AUB are associated with IUD malposition. No other risk factors were statistically or clinically significant. No linear combination of factors meaningfully predicted risk of IUD malposition. Radiologists were more likely to author reports describing malpositioned IUDs.
We aimed to identify the risk factors for intrauterine device (IUD) malposition and to develop a model to predict who is at risk for IUD malposition.
Methods:
We performed a retrospective cohort study of IUD users with ultrasounds performed between July 2014 to July 2017 within a large, urban, academic medical system. Our primary outcome was IUD malposition. Fisher's Exact Test and Wilcoxon Rank Sum test we used. We used logistic regression, least absolute shrinkage and selection operator (LASSO), and elastic net models to pred predict the likelihood of having a malpositioned IUD. IRB approval was obtained.
Results:
Of 1,759 ultrasound reports with an IUD present, 436 described a malpositioned IUD. Compared to participants with non-malpositioned IUDs, participants with malpositioned IUDs were more likely to be younger (30.7 and 31.9 years old, p=0.02), have fibroids (21.6% and 15.9%, p < 0.01), and have abnormal uterine bleeding (AUB) (19.7% and 14.9%, p=0.02). There were no differences between groups in gravidity, parity, uterine surgeries, number of cesarean deliveries, IUD type, or timing of IUD placement relative to abortion or delivery. Reports describing malpositioned IUDs were more likely to have been authored by radiologists than gynecologists (85.1% and 13.5%, p < 0.01). LASSO model, elastic net model, and logistic regression were unable to identify a meaningfully predictive model for IUD malpositionConclusion/Implications: Fibroids and AUB are associated with IUD malposition. No other risk factors were statistically or clinically significant. No linear combination of factors meaningfully predicted risk of IUD malposition. Radiologists were more likely to author reports describing malpositioned IUDs.
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