Objectives/Goals: The objective is to determine the relationship between prior progestin intrauterine device (IUD) use, duration of use, and adverse pregnancy outcomes and also to examine the return-time to fertility and whether demographic factors modify the effect of IUD use on pregnancy outcomes. Methods/Study Population: This is a prospective cohort study of 600 pregnant adults between 10 and 28 weeks of gestation who have not delivered a fetus. We will compare participants with and without prior progestin IUD use. Participants are recruited via flyers posted in university-associated OB-GYN clinics and via the health portal, MyChart. Participants complete a comprehensive contraception, medical, and pregnancy history and receive compensation. Pregnancies are followed until 6 weeks post-delivery, and outcomes are collected via the electronic health record. Pregnancy outcomes will be analyzed using multivariable logistic regression with adjustment for confounders, with sensitivity analyses stratified by duration of prior progestin IUD use. Results/Anticipated Results: We will characterize the prevalence and duration of progestin IUD use in the cohort and evaluate demographic factors associated with IUD use compared to other contraceptive methods. We will compare the rates of placental abnormalities, as well as miscarriage, preterm birth, hypertensive disorders of pregnancy, including preeclampsia and gestational hypertension, and other complications, between participants with prior progestin IUD use versus non-use. Among participants with prior IUD use, we will examine whether the risk of adverse pregnancy outcomes is associated with the length of use. We will also examine the time between the last contraceptive use and conception. Discussion/Significance of Impact: An association between prior progestin IUD use and pregnancy outcomes would be a novel finding and will have clinical implications for how contraceptive history may inform counseling and reproductive care. We hope that this study will rationalize the need for well-powered, larger studies to investigate the robustness of our study findings.
Aranda et al. (Wed,) studied this question.