Early coronavirus disease 2019 restrictive measures and changes in maternal characteristics, use of assisted reproductive technology, and stillbirth.
Early coronavirus disease 2019 restrictive measures and changes in maternal characteristics, use of assisted reproductive technology, and stillbirth.
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2019 早期冠状病毒病的限制措施和孕产妇特征的变化、辅助生殖技术的使用和死产。
DOI：
10.1111/ppe.12925
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发表时间：
2023
影响因子：
2.8
通讯作者：
Joseph,KS
中科院分区：
文献类型：
--
作者：
Lisonkova,Sarka;Bone,JeffreyN;Muraca,GiuliaM;Razaz,Neda;Boutin,Amelie;Brandt,JustinS;Bedaiwy,MohamedA;Ananth,CandeV;Joseph,KS
背景 最初的 COVID-19 大流行反应对使用辅助生殖技术 (ART) 后受孕的影响，以及对在大流行早期与大流行前期间受孕的妇女的母亲特征变化的影响尚未得到充分研究。 目的探讨 2020 年 3 月美国 (US) ART 诊所关闭对 ART 受孕的活产、多胎和死产频率的影响；方法基于人群的队列研究，包括 2015 年 1 月至 2020 年 12 月美国所有新生儿（22,907,688 例活产；134,537 例死产）。使用间断时间序列 (ITS) 方法来估计 2020 年 12 月预期发生率与观察到发生率的比率 (RR)（即主要在 2020 年 3 月出生的婴儿）。对 2020 年 3 月与 2015 年 3 月至 2019 年受孕的母亲之间的人口统计学和临床特征进行了比较。结果总体而言，1.1% 的活产和 1.7% 的死产是通过 ART 受孕的。 2020 年 12 月，ART 受孕的活产数下降了 57.0%（观察值与预期 RR 0.43，95% 置信区间 [CI] 0.40, 0.45），并且这些下降发生在所有女性亚组中。 2020 年 12 月，多胎出生率也有所下降。2020 年 12 月，ART 受孕婴儿的死产率有所增加（RR 2.55，95% CI 1.63，3.92），但非 ART 组的死产率保持不变。与大流行前相比，在大流行早期怀孕的妇女的母亲特征有所不同，其中包括孕前 3 级肥胖和慢性高血压的患病率增加。 结论 大流行期间 ART 诊所的早期关闭导致 2020 年 12 月 ART 受孕的活产数和多胎数大幅下降，并且 ART 受孕婴儿中死产的比例增加。在大流行早期怀孕的女性肥胖和慢性高血压的患病率也有所增加。
BackgroundThe initial COVID‐19 pandemic response−related effects on conceptions following the use of assisted reproductive technologies (ART), and on changes in the maternal characteristics of women who conceived during the early vs. pre‐pandemic period, have been understudied.ObjectivesTo examine the effects of ART clinic closures in the United States (US) in March 2020 on the frequency of ART‐conceived live births, multiple births and stillbirths; and to describe changes in the characteristics of women who conceived in the early pandemic period.MethodsPopulation‐based cohort study including all births in the US from January 2015 to December 2020 (22,907,688 live births; 134,537 stillbirths). Interrupted time series (ITS) methodology was used to estimate rate ratios (RR) of expected versus observed rates in December 2020 (i.e., among births conceived mainly in March 2020). Demographic and clinical characteristics were compared between mothers who conceived in March 2020 versus March 2015–2019.ResultsOverall, 1.1% of live births and 1.7% of stillbirths were conceived by ART. ART‐conceived live births decreased by 57.0% in December 2020 (observed vs. expected RR 0.43, 95% confidence interval [CI] 0.40, 0.45), and these declines occurred in all subgroups of women. Multiple births also declined in December 2020. Stillbirth rates increased in December 2020 in ART‐conceived births (RR 2.55, 95% CI 1.63, 3.92) but remained unchanged in the non‐ART group. Maternal characteristics of women who conceived in the early pandemic versus pre‐pandemic period differed and included an increased prevalence of pre‐pregnancy obesity class 3 and chronic hypertension.ConclusionsThe early pandemic closure of ART clinics resulted in a substantial decline in ART‐conceived live births and multiple births in December 2020 and an increase in the proportion of stillbirths among ART‐conceived births. Women who conceived in the early pandemic period also had an increased prevalence of obesity and chronic hypertension.