Correlation of Bacterial Infections in Women With and Without Intrauterine Devices

TL;DR

This study found that women with intrauterine devices (IUDs) had higher rates of certain bacterial infections compared to those without IUDs.

Contribution

The study provides new evidence on the correlation between IUD use and specific sexually transmitted bacterial infections.

Findings

IUD users had significantly higher rates of bacterial vaginosis and concurrent infections.

No significant difference was found for Mycoplasma/Ureaplasma infections between IUD users and non-users.

Age did not significantly affect infection rates, but IUD type influenced concurrent infections.

Abstract

Introduction: The goal of this study is to evaluate the correlation of bacterial infections acquired through sexual transmission, including Neisseria gonorrhea (NG), Chlamydia trachomatis (CT), Mycoplasma hominis (Myc), Ureaplasma urealyticus (Urea), and bacterial vaginosis (BV) in women and those who seek gynecologic care with a history of intrauterine device (IUD) placement versus those without a history of IUD placement.

Methods: A deidentified, retrospective analysis, with 234 test results within a large obstetrics and gynecology (OBGYN) practice in both Monmouth and Ocean County, New Jersey, from 2019 to 2020, was used to determine positivity rates of bacterial infections in both IUD users and non-IUD users. Fisher's exact and chi-squared tests were used to determine any association between the two groups.

Results: The study determined statistical variation among the two groups for BV positivity (p < 0.001), CT/NG (p = 0.03), and concurrent infections (p = 0.002). However, no statistical difference was noted for Myc/Urea infections (p = 0.05, 95% CI: 0.89-20.88, OR: 3.60). Furthermore, no statistical variation was determined by age. However, there was a statistical difference in concurrent infections by IUD types (p = 0.02, 95% CI: 0.00-0.87, OR: 0).

Conclusion: This study supports a statistically significant association between gonorrhea, chlamydia, and BV in women and those who seek gynecologic care with IUD usage. Our findings also reveal that age and nucleic acid amplification test (NAAT)-confirmed positivity for Mycoplasma/Ureaplasma do not exhibit statistically significant correlations between IUD users and non-IUD users. Given the clinical significance of providing patient education towards appropriate contraception use, our study furthers existing literature by shedding light on the correlation of IUD usage with infection.