Pregnancy loss among pregnancies conceived through assisted reproductive technology, United States, 1999-2002
Pregnancy loss among pregnancies conceived through assisted reproductive technology, United States, 1999-2002
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DOI：
10.1093/aje/kwm035
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发表时间：
2007-06-15
影响因子：
5
通讯作者：
Jamieson, Denise J.
中科院分区：
文献类型：
--
作者：
Farr, Sherry L.;Schieve, Laura A.;Jamieson, Denise J.
在美国，大约30%的怀孕可能以流产或死胎告终。通过辅助生殖技术（ART）受孕是否会增加流产风险尚不确定，关于孕产妇年龄、ART类型和胎龄特异性流产风险的数据有限。通过Kaplan-Meier方法分析了1999年至2002年期间148，494例ART妊娠的数据，以估计按母亲年龄和ART程序分层的14组特定孕龄后妊娠丢失的风险（条件风险）。出生、产妇死亡和人工流产都受到审查。Kaplan-Meier估计妊娠丢失的总风险为29%，但范围为22%至63%，取决于患者年龄和ART程序。妊娠6周时，58%的妊娠丢失发生。条件性流产风险在妊娠6周时为10%-45%，妊娠早期为2%-7%，妊娠20周后小于2%。结果可用于咨询ART患者，并为未来关于妊娠丢失病因的研究提供信息。
Approximately 30% of pregnancies in the United States may end in miscarriage or stillbirth. Whether pregnancies conceived through assisted reproductive technology (ART) are at an increased risk of loss is inconclusive, and data on maternal age-, ART type-, and gestational age-specific risk of loss are limited. Data on 148,494 ART pregnancies conceived from 1999 through 2002 were analyzed by use of the Kaplan-Meier method to estimate risks of pregnancy loss after specified gestational ages (conditional risk) for 14 groups stratified by maternal age and ART procedure. Births, maternal deaths, and induced abortions were censored. The Kaplan-Meier estimate of total risk of pregnancy loss was 29% but ranged from 22% to 63% depending on patient age and ART procedure. By 6 weeks' gestation, 58% of all pregnancy losses occurred. Conditional risk of pregnancy loss ranged from 10% to 45% at 6 weeks' gestation and from 2% to 7% at the first trimester; it was less than 2% after 20 weeks' gestation. Results can be used to counsel ART patients and inform future research on the etiology of pregnancy loss.