Use of the Copper T380A intrauterine device by adolescent mothers: continuation and method failure

Study objective: This report contributes to limited empirical data regarding use of the Copper T380A intrauterine device among adolescent mothers.

Design: We conducted a retrospective case series of adolescent mothers aged 15 to 21 years whose index delivery occurred before age 18 and met study inclusion criteria.

Setting: All adolescent mothers received obstetrics and gynecology care at one urban clinical site in Washington, DC.

Participants: All participated in a teen secondary pregnancy prevention program from April 2002 to November 2008 and used the Copper T380A intrauterine device.

Main outcome measures: We abstracted data to evaluate intrauterine device utilization, expulsion, removal, and pregnancy diagnosis.

Results: Thirty-nine adolescent mothers met inclusion criteria. Six patients had partial or complete expulsion (15%; 95% CI, 6-29), and 10 requested removal (26%; 95% CI, 14-41) within 24 months of placement. Four users (10%; 95% CI, 3-23) became pregnant. Three had an intrauterine device in place at time of conception, while one became pregnant due to unrecognized device expulsion.

Conclusions: In this case series, many adolescent mothers discontinued Copper T380A use within two years of placement. The numbers of patients were too limited to provide stable estimates of contraceptive effectiveness. Larger comparative studies will further evaluate both effectiveness and acceptability of this device among teen mothers.