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March 9, 1984

Intrauterine Devices and Pelvic Inflammatory Disease

Author Affiliations

Family Health International Research Triangle Park, NC

JAMA. 1984;251(10):1278. doi:10.1001/jama.1984.03340340020011

To the Editor.—  The finding of Kaufman et al1 that the Dalkon Shield is associated with a 6.5-fold higher risk of pelvic inflammatory disease (PID) compared with copper-bearing intrauterine (contraceptive) devices (IUDs) and a 3.7-fold higher risk compared with the Lippes Loop is curious in terms of the scientific evidence regarding the association between IUD use and the risks of PID. This is especially true in view of our recent extensive review of the literature2 that showed a similar risk of PID for all types of IUDs. We were puzzled by the following findings of Kaufman et al.

  1. The relative risk of PID for Dalkon Shield users (11 cases, two controls) was compared with that for copper-bearing IUD users and Lippes Loop users. The authors state that "comparisons with other IUDs were not feasible because of small numbers," but there were more Saf-T-Coil (eight cases, six controls)