Journal of School of Public Health and

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The Intrauterine device (IUD) is very effective in preventing pregnancy, it is the cheapestform of birth control in the long run, allows almost immediate return to normal life andwork, and it can be used as an alternative to hormonal methods of emergencycontraception.This study was designed to assess factors causing IUD iscontinuation. It is a cross-sectional study among 343 women in Urmia in 2001 who had had lUD'splanted back in 1998.Within 3 years, more than 50 percent had theirlUD's removed. The 1-year IUD survivalrate was 62 percent and the 3-year rate about 42 percent.54.5 percent of users had at least one complication (P=0.000). The main complications were: Bleeding 28.7% , Pain 27.3% and Infection 18.5%.In cases where the device was planted by a midwife, the overall removal rate was 62.5%(p= 0.009). Pregnancy rate was 0.49% per 100 woman - year and the IUD expulsion ratewas 6.5%o.Bleeding is clearly the most common complication. If cases are chosen more carefully, the effective life of device will probably increase.

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Background and Aim: Unwanted pregnancy is a widespread problem globally and in Iran, which can lead to low birth weight (LBW)-one of the most important causes of mortality in newborns. This study was conducted to assess the risk factors among women with unwanted pregnancies leading to delivery of LBW infants. Other LBW risk factors were also studied.

Methods and Materials: This was a prospective cohort study performed during March 2004 to April 2005 in the health centers of Shemiran, north of Tehran, Iran. A sample of 180 mothers, 15-49 years old, with an unwanted pregnancy (case group) and 430 mothers, in the same age group, with a wanted pregnancy (control group) were compared. To determine the effect of unwanted pregnancy three major type of variables (background, maternal, and neonatal variables) were selected, and the mothers were followed up for 11-12 months (from the first referral for prenatal care to about 2 months after delivery). Statistical univariate analyses were performed using the t- and χ2 tests. Also, multiple logistic regression was employed to identify the risk factors associated with LBW. SPSS 11.5 for windows was used for data analysis.

Results: The unwanted pregnancy prevalence was 11.7%. The mean of Apgar score was 8.6 in the case group and 8.9 in the control group, the difference being statistically significant (p<0.001).Mean birth `1234t5weight of neonate in the case group was about 2.984kg vs. 3.14kg in the control group, and the difference was statistically significant (p<0.001) . Univariate analysis showed that LBW was related to unwanted pregnancy (p<0.001), gestational age (p<0.001), mother's age (p<0.001), mother's marriage age (p<0.001), birth order (p<0.001), number of past pregnancies (p<0.001), family size (p<0.001), number of abortions (p<0.001), attempt to abort (p<0.001), high blood pressure (p<0.001), and diabetes (p<0.001). Finally, multivariable analysis revealed that LBW was only associated with unwanted pregnancy, high blood pressure, and diabetes in mothers, with adjusted odd ratios of 2.22, 2.81 and 3.55, respectively (p<0.05).

Conclusion: Prevention of unwanted pregnancies, increased gestational age, and appropriate management of mothers' chronic diseases can reduce the risk of LBW.