Trends in Severe Maternal Morbidity After Assisted Reproductive Technology in the United States, 2008-2012
Trends in Severe Maternal Morbidity After Assisted Reproductive Technology in the United States, 2008-2012
复制标题
DOI：
10.1097/aog.0000000000001197
复制
发表时间：
2016-01-01
影响因子：
7.2
通讯作者：
Boulet, Sheree L.
中科院分区：
文献类型：
--
作者：
Martin, Angela S.;Monsour, Michael;Boulet, Sheree L.
目的：研究2008年至2012年在使用或不使用辅助生殖技术（ART）的妊娠中分娩和产后住院的严重孕产妇发病率的趋势。方法：在这项回顾性队列研究中，在2008-2012年Truven健康市场扫描商业声明和遭遇数据库中确定分娩。使用《国际疾病分类》第九次修订版、《临床修改诊断代码》和《现行程序术语代码》确定了严重的孕产妇发病率。计算ART和非ART妊娠的严重孕产妇发病率。我们进行了多变量逻辑回归，控制了产妇特征，并计算了严重发病率的校正优势比（ORs）和95%置信区间（CIs）。此外，在ART和非ART分娩之间进行倾向评分分析。结果：在1,016,618例分娩中，14,761例（1.5%）被确定为ART妊娠。输血是抗逆转录病毒治疗和非抗逆转录病毒治疗妊娠最常见的严重发病率指标。每1万例单胎分娩中，有273例抗逆转录病毒治疗分娩或产后住院，而非抗逆转录病毒治疗有126例
OBJECTIVE: To examine trends in severe maternal morbidity from 2008 to 2012 in delivery and postpartum hospitalizations among pregnancies conceived with or without assisted reproductive technology (ART).METHODS: In this retrospective cohort study, deliveries were identified in the 2008-2012 Truven Health Market-Scan Commercial Claims and Encounters Databases. Severe maternal morbidity was identified using International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes and Current Procedural Terminology codes. Rate of severe maternal morbidity was calculated for ART and non-ART pregnancies. We performed multivariable logistic regression, controlling for maternal characteristics, and calculated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for severe morbidity. Additionally, a propensity score analysis was performed between ART and non-ART deliveries.RESULTS: Of 1,016,618 deliveries, 14,761 (1.5%) were identified as pregnancies conceived with ART. Blood transfusion was the most common severe morbidity indicator for ART and non-ART pregnancies. For every 10,000 singleton deliveries, there were 273 ART deliveries or postpartum hospitalizations with severe maternal morbidity compared with 126 for non-ART (P