Factors associated with discontinuation rates of the Copper T380A IUD in aPeruvian public hospital

The objectives of this study were to evaluate performance and causes of dis continuation of the Copper T380A IUD by users at the Family Planning Servic e at Hospital Arzobispo Loayza in Lima, Peru, during a period of three year s. The study included 3167 acceptors of the CuT380A attending the service d uring 1992-1994. IUDs were inserted during interval timing. Follow-up was a t 1, 12, 24 and 36 months after insertion. The following events were record ed: number of pregnancies, expulsions and all causes of discontinuation. Th e cumulative rates per 100 woman-years using the life-table method was calc ulated. Also calculated were the relative risks for expulsion and for pregn ancy. At the end of the study, 361 women had discontinued the method for va rious reasons, whereas 1667 women continued using the method. The lost-to-f ollow-up proportion increased over time from 35.9 per 100 woman-years for t he first year to 38.2 for the third year. The cumulative discontinuation ra te over three years was 22.6 +/-1.3 (cumulative rate +/- standard error) pe r 100 woman-years. The cumulative pregnancy rate for three years was 1.2 +/ -0.4 per 100 woman-years, whereas the cumulative rate of expulsion was 4.9 +/-0.4 for the first, 6.4 for the second and 6.8 for the third year. The ma in cause of discontinuation during the first year of use was expulsion (4.9 per 100 woman-years) followed by personal reasons (2.1 per 100 woman-years ). At the end of the third year, the main cause was personal reasons (11.4) and the second cause was expulsion (6.8). A higher probability of expulsio n, pregnancy and discontinuation for bleeding and/or pain was associated wi th age less than 20 years. In conclusion, the effectiveness of the CuT380A IUD after three years of use was 98.8 per 100 woman-years, whereas continua tion was 39.2, and loss to follow-up increased over time.