Trial Outcomes & Findings for Early Postpartum Intrauterine Device (IUD) Placement (NCT NCT01594476)

NCT ID: NCT01594476

Last Updated: 2019-01-11

Results Overview

Subjects will be contacted by phone or email at 3 months after delivery. We will compare the proportion of subjects who report having an IUD in place at 3 months after delivery of those who are randomized to each group (placement at either 3 weeks or 6 weeks) .

Recruitment status

TERMINATED

Study phase

PHASE4

Target enrollment

201 participants

Primary outcome timeframe

Three months after delivery

Results posted on

2019-01-11

Participant Flow

Participant milestones

Participant milestones
Measure
IUD Insertion at 3 Weeks
IUD placement at 3 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS or Copper T intrauterine device
IUD Insertion at 6 Weeks
IUD placement at 6 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS or Copper T intrauterine device
Overall Study
STARTED
101
100
Overall Study
Received Intervention
66
73
Overall Study
Excluded After Allocation
1
3
Overall Study
IUD Removal
3
5
Overall Study
IUD Expulsion
2
0
Overall Study
Pregnant
2
5
Overall Study
COMPLETED
100
97
Overall Study
NOT COMPLETED
1
3

Reasons for withdrawal

Reasons for withdrawal
Measure
IUD Insertion at 3 Weeks
IUD placement at 3 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS or Copper T intrauterine device
IUD Insertion at 6 Weeks
IUD placement at 6 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS or Copper T intrauterine device
Overall Study
Protocol Violation
1
3

Baseline Characteristics

Early Postpartum Intrauterine Device (IUD) Placement

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Levonorgestrel IUS Insertion at 3 Weeks
n=100 Participants
IUD placement at 3 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
Levonorgestrel IUS Insertion at 6 Weeks
n=97 Participants
IUD placement at 6 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
Total
n=197 Participants
Total of all reporting groups
Age, Continuous
27.8 years
STANDARD_DEVIATION 5.7 • n=5 Participants
29.0 years
STANDARD_DEVIATION 5.8 • n=7 Participants
28.6 years
STANDARD_DEVIATION 6.4 • n=5 Participants
Sex: Female, Male
Female
100 Participants
n=5 Participants
97 Participants
n=7 Participants
197 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
14 Participants
n=5 Participants
13 Participants
n=7 Participants
27 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
86 Participants
n=5 Participants
84 Participants
n=7 Participants
170 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Insurance type
Public insurance
48 Participants
n=5 Participants
47 Participants
n=7 Participants
95 Participants
n=5 Participants
Insurance type
Private insurance
52 Participants
n=5 Participants
50 Participants
n=7 Participants
102 Participants
n=5 Participants
Planned pregnancy
Unplanned
49 Participants
n=5 Participants
48 Participants
n=7 Participants
97 Participants
n=5 Participants
Planned pregnancy
Planned
51 Participants
n=5 Participants
49 Participants
n=7 Participants
100 Participants
n=5 Participants
Delivery type
Vaginal
75 Participants
n=5 Participants
71 Participants
n=7 Participants
146 Participants
n=5 Participants
Delivery type
Cesarean
25 Participants
n=5 Participants
26 Participants
n=7 Participants
51 Participants
n=5 Participants
Education
High school/GED or less
31 Participants
n=5 Participants
23 Participants
n=7 Participants
54 Participants
n=5 Participants
Education
More than high school
69 Participants
n=5 Participants
74 Participants
n=7 Participants
143 Participants
n=5 Participants
Snyder Hope Scale
Future Scale total score
47.2 units on a scale
STANDARD_DEVIATION 5.4 • n=5 Participants
45.9 units on a scale
STANDARD_DEVIATION 6.7 • n=7 Participants
46.5 units on a scale
STANDARD_DEVIATION 6.1 • n=5 Participants
Snyder Hope Scale
Agency subscale score
23.8 units on a scale
STANDARD_DEVIATION 3.0 • n=5 Participants
22.9 units on a scale
STANDARD_DEVIATION 4.1 • n=7 Participants
23.4 units on a scale
STANDARD_DEVIATION 3.6 • n=5 Participants
Snyder Hope Scale
Pathway subscale score
23.4 units on a scale
STANDARD_DEVIATION 3.2 • n=5 Participants
22.8 units on a scale
STANDARD_DEVIATION 3.8 • n=7 Participants
23.1 units on a scale
STANDARD_DEVIATION 3.5 • n=5 Participants
Social-Support Scale
MDSS total score
65.8 units on a scale
STANDARD_DEVIATION 9.0 • n=5 Participants
63.5 units on a scale
STANDARD_DEVIATION 10.7 • n=7 Participants
64.7 units on a scale
STANDARD_DEVIATION 9.8 • n=5 Participants
Social-Support Scale
Family subscale score
22.0 units on a scale
STANDARD_DEVIATION 3.6 • n=5 Participants
20.4 units on a scale
STANDARD_DEVIATION 5.6 • n=7 Participants
21.2 units on a scale
STANDARD_DEVIATION 4.7 • n=5 Participants
Social-Support Scale
Friends subscale score
21.3 units on a scale
STANDARD_DEVIATION 4.2 • n=5 Participants
20.5 units on a scale
STANDARD_DEVIATION 5.2 • n=7 Participants
20.9 units on a scale
STANDARD_DEVIATION 4.7 • n=5 Participants
Social-Support Scale
Significant other subscale score
23.0 units on a scale
STANDARD_DEVIATION 2.0 • n=5 Participants
22.4 units on a scale
STANDARD_DEVIATION 3.2 • n=7 Participants
22.7 units on a scale
STANDARD_DEVIATION 2.7 • n=5 Participants

PRIMARY outcome

Timeframe: Three months after delivery

Population: Data analyzed as intent to treat regardless of when they had their IUD placed. This is IUD placed by 3 months in each group.

Subjects will be contacted by phone or email at 3 months after delivery. We will compare the proportion of subjects who report having an IUD in place at 3 months after delivery of those who are randomized to each group (placement at either 3 weeks or 6 weeks) .

Outcome measures

Outcome measures
Measure
IUD Insertion at 3 Weeks
n=100 Participants
IUD placement at 3 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
IUD Insertion at 6 Weeks
n=97 Participants
IUD placement at 6 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
18-24 Days After Cesarean Delivery
IUD placement at 18-24 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
39-45 Days After Cesarean Delivery
IUD placement at 39-45 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
Subjects With an IUD at 3 Months Postpartum
66 Participants
73 Participants

SECONDARY outcome

Timeframe: Immediately following IUD placement.

Population: Includes all subjects enrolled on protocol who underwent IUD placement at a study visit at any timing prior to 3 months postpartum. Comparison is based on randomization timing but actual timing of placement may have differed. Numbers differ from primary outcome due to removals and expulsion prior to 3 months, and placement outside study visits.

Subjects were asked to record their overall satisfaction with the timing of the IUD placement on a 100 millimeter (mm) visual analog scale (VAS). A VAS is a 100 mm horizontal line with anchors stating "very dissatisfied" and "very satisfied." The VAS score is calculated by measuring the distance in millimeters between the left end of the scale and the intersection of a vertical mark placed by the subject. Maximum score is 100 (range 0-100). Higher scores indicate higher satisfaction.

Outcome measures

Outcome measures
Measure
IUD Insertion at 3 Weeks
n=68 Participants
IUD placement at 3 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
IUD Insertion at 6 Weeks
n=68 Participants
IUD placement at 6 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
18-24 Days After Cesarean Delivery
IUD placement at 18-24 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
39-45 Days After Cesarean Delivery
IUD placement at 39-45 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
Satisfaction With the Timing of IUD Placement.
90.6 mm on VAS
Standard Deviation 17.2
93.5 mm on VAS
Standard Deviation 12.0

SECONDARY outcome

Timeframe: At IUD placement

Population: Subjects who had their IUD placed at the allocated timing of 18-24 days versus 39-45 days

Transvaginal ultrasound will be performed immediately following IUD placement. The thickness of the uterine myometrium at the fundus from the endometrium to the outer edge of the serosa will be measured in centimeters using an ultrasound caliper in the sagittal view.

Outcome measures

Outcome measures
Measure
IUD Insertion at 3 Weeks
n=54 Participants
IUD placement at 3 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
IUD Insertion at 6 Weeks
n=61 Participants
IUD placement at 6 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
18-24 Days After Cesarean Delivery
IUD placement at 18-24 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
39-45 Days After Cesarean Delivery
IUD placement at 39-45 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
Uterine Thickness at the Fundus
2.3 cm
Standard Deviation 0.8
1.7 cm
Standard Deviation 0.4

SECONDARY outcome

Timeframe: Six months after delivery

Population: Population is subject randomization groups.

Subjects will return to clinic for an ultrasound and exam at six months after delivery. We will compare the proportion of subjects with an IUD at this time of those randomized to each placement timing.

Outcome measures

Outcome measures
Measure
IUD Insertion at 3 Weeks
n=100 Participants
IUD placement at 3 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
IUD Insertion at 6 Weeks
n=97 Participants
IUD placement at 6 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
18-24 Days After Cesarean Delivery
IUD placement at 18-24 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
39-45 Days After Cesarean Delivery
IUD placement at 39-45 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
Subjects With an IUD at 6 Months Postpartum
53 Participants
53 Participants

SECONDARY outcome

Timeframe: Six months after delivery

Population: All subjects analyzed. This includes all subjects enrolled on protocol and allocated. There were no adverse events in the subjects excluded after allocation.

Subjects will be followed for 6 months each. Over the 6 month study period, the number and proportion of subjects who experience adverse events including treatment for infection, IUD expulsion or IUD perforation will be assessed.

Outcome measures

Outcome measures
Measure
IUD Insertion at 3 Weeks
n=100 Participants
IUD placement at 3 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
IUD Insertion at 6 Weeks
n=97 Participants
IUD placement at 6 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
18-24 Days After Cesarean Delivery
IUD placement at 18-24 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
39-45 Days After Cesarean Delivery
IUD placement at 39-45 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
Number of Subjects With Adverse Events
IUD expulsion
2 Participants
0 Participants
Number of Subjects With Adverse Events
IUD perforation
0 Participants
0 Participants
Number of Subjects With Adverse Events
Pregnancy with IUD in place
0 Participants
0 Participants
Number of Subjects With Adverse Events
Infection with IUD in place
0 Participants
0 Participants
Number of Subjects With Adverse Events
No known adverse events
98 Participants
97 Participants

SECONDARY outcome

Timeframe: At the time of IUD placement.

Population: Subjects analyzed by actual timing of IUD insertion

Subjects were asked to record their current pain immediate at the time of the IUD placement on a 100 millimeter (mm) visual analog scale (VAS). A VAS is a 100 mm horizontal line with anchors stating "no pain" and "worst pain in my life." The VAS score is calculated by measuring the distance in millimeters between the left end of the scale and the intersection of a vertical mark placed by the subject. Maximum score is 100 (range 0-100). Higher scores indicate higher pain. The distance from the left side of the 10 cm line to the mark will be measured in millimeters and compared between randomization groups if they received an IUD at the allocated timing of 18-24 or 39-45 days.

Outcome measures

Outcome measures
Measure
IUD Insertion at 3 Weeks
n=39 Participants
IUD placement at 3 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
IUD Insertion at 6 Weeks
n=47 Participants
IUD placement at 6 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
18-24 Days After Cesarean Delivery
n=16 Participants
IUD placement at 18-24 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
39-45 Days After Cesarean Delivery
n=14 Participants
IUD placement at 39-45 days after cesarean delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
Pain With IUD Placement
15.7 mm
Standard Deviation 16.4
23.0 mm
Standard Deviation 21.0
30.9 mm
Standard Deviation 27.3
32.1 mm
Standard Deviation 27.9

Adverse Events

IUD Insertion at 3 Weeks

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

IUD Insertion at 6 Weeks

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
IUD Insertion at 3 Weeks
n=100 participants at risk
IUD placement at 3 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
IUD Insertion at 6 Weeks
n=97 participants at risk
IUD placement at 6 weeks after delivery. Levonorgestrel IUS: 20 mcg levonorgestrel per day in intrauterine system for Mirena IUS Copper T intrauterine device
Reproductive system and breast disorders
IUD expulsion
2.0%
2/100 • Number of events 2
0.00%
0/97

Additional Information

Dr. Maureen Baldwin, MD MPH

Oregon Health & Science University

Phone: (503) 494-9762

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place