Hospital care utilization of infants born after IVF
Hospital care utilization of infants born after IVF
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DOI：
10.1093/humrep/17.4.929
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发表时间：
2002-04-01
影响因子：
6.1
通讯作者：
Källén, B
中科院分区：
文献类型：
--
作者：
Ericson, A;Nygren, KG;Källén, B
背景：体外受精后出生的婴儿通常是双胞胎，单胎体外受精婴儿早产的风险增加。这两种情况都可能增加发病率。我们检查了体外受精后出生的婴儿需要住院的频率和持续时间，并将这些信息与同一时期在瑞典出生的所有婴儿进行了比较。方法：我们使用了从1984年到1997年的全国试管受精妊娠登记和截至1998年底的全国住院护理登记。我们确定了9056名接受IVF治疗的活产儿，并与1417166名非IVF活产儿进行了比较。结果：新生儿住院的优势比最高(OR类似于3)，但6岁以下儿童的优势比(OR)增加(1.2-1.3)。试管受精后住院的OR是1.8，但当分析局限于足月婴儿时，OR是1.3，然后这一过剩可以用母亲的不孕不育来解释。因脑瘫(1.7)、癫痫(1.5)、先天性畸形(1.8)或肿瘤(1.6)，以及哮喘(1.4)或任何感染(1.4)住院的OR显著增加。当使用瑞典癌症登记处的信息时，没有发现儿童癌症的额外风险。试管婴儿和非试管婴儿的平均住院天数分别为9.5天和3.6天。结论：试管婴儿住院率的增加在很大程度上是由于多胎发生率的增加。因此，与此相关的增加的成本可以通过使用单一胚胎移植来减少，而节省的医疗费用将被维持妊娠率所需的胚胎移植周期的增加所抵消。
BACKGROUND: Infants born after IVF are often twins, and singleton IVF babies have an increased risk for preterm birth. Both conditions are likely to increase morbidity. We examined the frequency and duration of hospitalization required by babies born after IVF, and compared this information with all infants born in Sweden during the same time period. METHODS: We used a nationwide registration of IVF pregnancies from 1984 to 1997 and a nationwide register of all in-patient care up to the end of 1998. We identified 9056 live born infants after IVF treatment and compared them with 1 417 166 non-IVF live born infants. RESULTS: The highest odds ratio (OR similar to3) was seen for neonatal hospitalization, but an increased OR (1.2-1.3) was noted for children up to 6 years of age. The OR for being hospitalized after IVF was 1.8, but when the analysis was restricted to term infants it was 1.3 and this excess was then explainable by maternal subfertility. Statistically significant increased ORs were seen for hospitalization for cerebral palsy (1.7), epilepsy (1.5), congenital malformation (1.8) or tumour (1.6), but also for asthma (1.4) or any infection (1.4). When information from the Swedish Cancer Registry was used, no excess risk for childhood cancer was found. The average number of days spent in hospital by IVF and non-IVF children was 9.5 and 3.6 respectively. CONCLUSIONS: The increased hospitalization of IVF children is, to a large extent, due to the increased incidence of multiple births. Therefore, the increased costs associated with this may be reduced by the use of single embryo transfers, with the savings in health care costs being offset against the increased number of embryo transfer cycles required to maintain the pregnancy rate.