{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T15:12:10Z","timestamp":1776093130272,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study assessed the incidence of and risk factors associated with expulsion of copper intrauterine devices inserted in the immediate postpartum period at a public hospital in Brazil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included women who had a copper intrauterine device (IUD) inserted immediately after delivery at a teaching hospital and returned for follow\u2010up within 12\u2009months. The primary outcome was IUD expulsion (partial or complete) overall and by mode of delivery. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for expulsion. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 543 participants, the overall expulsion rate was 14.7%, with significantly higher rates for placement after vaginal delivery (22.8%) compared to cesarean section (5.2%). In bivariate analysis, maternal age, parity, gestational age, mode of delivery, and insertion by first\u2010year residents were associated with device expulsion. In multivariate analysis, maternal age &lt;20\u2009years (aOR 5.03, 95% CI: 1.30\u201319.42), age 20\u201334\u2009years (aOR 4.68, 95% CI: 1.40\u201315.63), and vaginal delivery (aOR 5.78, 95% CI: 2.17\u201315.42) remained independently associated with IUD expulsion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At a Brazilian teaching hospital, nearly 15% of the women who had a copper IUD inserted by residents in the immediate postpartum period expelled the device. Maternal age under 35\u2009years and vaginal delivery were significant risk factors for expulsion. These findings highlight the importance of individualized counseling and close follow\u2010up for higher\u2010risk groups, as well as continuous training of providers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70644","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T07:08:00Z","timestamp":1762326480000},"page":"397-402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and risk factors for postplacental intrauterine device expulsion in a Brazilian hospital"],"prefix":"10.1002","volume":"173","author":[{"given":"Silvana A.","family":"Giovanelli","sequence":"first","affiliation":[{"name":"Obstetrics Department Universidade Federal de S\u00e3o Paulo (UNIFESP) Escola Paulista de Medicina  S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4944-0720","authenticated-orcid":false,"given":"Maria Regina","family":"Torloni","sequence":"additional","affiliation":[{"name":"Obstetrics Department Universidade Federal de S\u00e3o Paulo (UNIFESP) Escola Paulista de Medicina  S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina A. F.","family":"Guazzelli","sequence":"additional","affiliation":[{"name":"Obstetrics Department Universidade Federal de S\u00e3o Paulo (UNIFESP) Escola Paulista de Medicina  S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1020-49892002000300013"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12503"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30315-6"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.8877"},{"key":"e_1_2_8_6_1","unstructured":"World Health Organisation.Medical Eligibility Criteria for Contraceptive Uses Fifth Edition [WHO website].2015Accessed May 12 2025.https:\/\/www.who.int\/publications\/i\/item\/9789241549158"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30481-9"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2013.11.011"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.70146"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.02.045"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.48474"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2020.11.003"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14081"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1759628"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.4274\/jtgga.galenos.2020.2020.0037"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13806"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2021.10.009"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/7695847"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2018.11.003"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13787"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005000"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1693677"},{"key":"e_1_2_8_23_1","article-title":"Follow\u2010up visit after post\u2010placental copper intrauterine device insertion (TCu 380A)","volume":"22","author":"Silva CS","year":"2023","journal-title":"Cienc Cuid Saude"},{"issue":"3","key":"e_1_2_8_24_1","article-title":"Longitudinal care: factors associated with adherence to postpartum follow\u2010up according to data from PMAQ\u2010AB","volume":"38","author":"Baratieri T","year":"2022","journal-title":"Cad Saude Publica"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12600"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.11.019"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70644","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.70644","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70644","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T14:24:29Z","timestamp":1776090269000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.70644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/ijgo.70644"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.70644","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,4]]},"assertion":[{"value":"2025-09-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}