{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:28:33Z","timestamp":1787099313987,"version":"build-2736575974"},"reference-count":49,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"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":["BJOG"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unintended pregnancy and repeat abortion remain significant challenges in the field of reproductive health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To summarize evidence from systematic reviews and meta\u2010analyses (SRMAs) comparing immediate versus delayed long\u2010acting reversible contraception (LARC) insertion in postpartum and postabortion populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search Strategy<\/jats:title>\n                    <jats:p>Five databases were systematically searched in April 2025 without restrictions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection Criteria<\/jats:title>\n                    <jats:p>SRMAs were included if they assessed the possible health outcomes between immediate and delayed LARC insertions for postabortion or postpartum populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection and Analysis<\/jats:title>\n                    <jats:p>Pooled results were extracted as reported, with most effect sizes presented as relative risks (RRs) with 95% confidence intervals (CIs). Eligible SRMAs were assessed utilizing AMSTAR\u20102 for methodological quality. Evidence certainty was assessed by GRADE tool or predefined criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>From 1998 screened records, nine SRMAs were included, yielding 92 comparisons. Compared with the delayed group, postpartum women in the immediate group had higher LARC initiation, higher 6\u2010month LARC utilization and lower 6\u2010month pregnancy rates (RR, 0.16; 95% CI, 0.04\u20130.71; moderate\u2010certainty evidence). Similar comparison results of such outcomes were discovered in postabortion populations. However, immediate intrauterine device insertion significantly increased the risk of expulsion, especially in the vaginal delivery subgroup for postpartum populations (RR, 5.09; 95% CI, 2.04\u201312.73; high\u2010certainty evidence) and in the first trimester subgroup for medical abortion populations (RR, 2.02; 95% CI, 1.37\u20132.98; moderate\u2010certainty evidence).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with delayed insertion, immediate LARC placement after delivery (moderate\u2010certainty) or abortion (low\u2010certainty) was more effective in preventing unintended pregnancies. Additionally, abortion methods should be considered in future guideline updates, though supporting evidence was of low\u2010certainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO number: CRD420251031374<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70248","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:28:38Z","timestamp":1776644918000},"page":"1837-1848","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immediate Versus Delayed Postpartum and Postabortion Insertion of Long\u2010Acting Reversible Contraception: An Umbrella Review"],"prefix":"10.1111","volume":"133","author":[{"given":"Yazhen","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health Southeast University  Nanjing China"},{"name":"Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yidan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuening","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Health Commission (NHC) Key Laboratory of Contraceptives Vigilance and Fertility Surveillance  Nanjing China"},{"name":"Jiangsu Health Development Research Center  Nanjing China"},{"name":"Jiangsu Provincial Medical Key Laboratory of Fertility Protection and Health Technology Assessment  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinglong","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Health Commission (NHC) Key Laboratory of Contraceptives Vigilance and Fertility Surveillance  Nanjing China"},{"name":"Jiangsu Health Development Research Center  Nanjing China"},{"name":"Jiangsu Provincial Medical Key Laboratory of Fertility Protection and Health Technology Assessment  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayu","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Health Economics and Management Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mincong","family":"Jin","sequence":"additional","affiliation":[{"name":"International School Affiliated to Nanjing University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0071-9755","authenticated-orcid":false,"given":"Hui","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health Southeast University  Nanjing China"},{"name":"Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2214\u2010109x(20)30315\u20106"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13620"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000005693"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.05.013"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000002174"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13524\u2010014\u20100359\u20109"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1608736"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7303a1"},{"key":"e_1_2_12_10_1","volume-title":"Selected Practice Recommendations for Contraceptive Use","author":"World Health Organization","year":"2016"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dew238"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2017.07.085"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.14802"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31822ade67"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.03.007"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013565.pub2"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010024\u201062327\u20101"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.081086"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643\u2010019\u20101252\u20109"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.934475"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4008"},{"key":"e_1_2_12_22_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version","author":"Pollock M.","year":"2020"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.09.019"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011913.pub3"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2019.1665175"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003988.pub2"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2009.03.024"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2021.01.017"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001777.pub4"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(22)00015\u20100"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.01.003"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181f73fac"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2016.07.004"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2014.971454"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003036.pub3"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmz040"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011913.pub2"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000005293"},{"key":"e_1_2_12_39_1","volume-title":"Medical Eligibility Criteria for Contraceptive Use","author":"Health WHOR","year":"2010"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.48474"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.03.003"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2008.03.003"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2013.05.012"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1080\/03630242.2019.1616042"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nwh.2017.04.003"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.02.011"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.12984"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2014.05.007"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh\u20102022\u2010201579"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deu233"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.70248","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.70248","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.70248","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:18:27Z","timestamp":1787098707000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.70248"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,19]]},"references-count":49,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/1471-0528.70248"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.70248","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,19]]},"assertion":[{"value":"2025-08-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}