Fertility treatments and the risk of preterm birth among women with subfertility: a linked-data retrospective cohort study.
Fertility treatments and the risk of preterm birth among women with subfertility: a linked-data retrospective cohort study.
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生育力低下妇女的生育治疗和早产风险：一项关联数据回顾性队列研究
DOI：
10.1186/s12978-022-01363-4
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发表时间：
2022-03-29
影响因子：
3.4
通讯作者：
Stanford JB
中科院分区：
文献类型：
--
作者：
Sanders JN;Simonsen SE;Porucznik CA;Hammoud AO;Smith KR;Stanford JB
试管受精(IVF)出生每年在早产(PTB)中占相当大的比例。然而，对于侵入性较小的生育治疗，没有对不良围产期结局的正式监测。这项研究的目的是描述生育治疗(体外受精、宫内受精，通常使用排卵药物(IUI)或单独使用排卵药物)与早产之间的关系，并与不育女性的不治疗进行比较。生育经验研究(FES)是犹他大学在2010年4月至2012年9月期间进行的一项回溯性队列研究。有原发不孕症病史的妇女通过调查和访谈自我报告治疗数据。参与者的数据与出生证明和胎儿死亡记录有关，以评估围产期结局，特别是早产。完成调查问卷的研究参与者共有487份出生证明和3份胎儿死亡记录被链接为第一胎。在关联出生中，19%的人患有肺结核。在调整了母亲年龄、父亲年龄、母亲文化程度、年收入、宗教信仰、男性或女性生育诊断和亚生育时间后，使用排卵药物妊娠的肺结核的优势比和95%可信区间(CI)分别为2.17(CI 0.99，4.75)、3.17(CI 1.4，7.19)和4.24(CI 2.05，8.77)。据报道，女性因素不孕症的诊断增加了调整后的肺结核2.99的几率(可信区间1.5，5.97)。尝试怀孕的持续时间与肺结核没有独立的联系。在将分析局限于单胎妊娠时，优势比对于任何类型的治疗都不显著。体外受精、人工授精和排卵药物都与早产和低出生体重的发生率高相关，主要与多胎出生有关。网上版载有补充材料，可在10.1186/s12978-022-01363-4查阅。体外受精等不孕不育治疗与早产有关，但对其他侵入性较小的治疗方法如何导致早产知之甚少。这项研究比较了不同类型的生育治疗和早产率，这些妇女也在与不孕症作斗争，但在怀孕时没有使用生育治疗。2010年至2012年间，犹他大学招收了490名女性。参与者被要求完成一项调查，并被链接到出生证明和胎儿死亡证明数据。使用体外受精的女性早产的可能性是不使用治疗的女性的4.24倍。使用宫内受精的早产可能性是那些在受孕时不使用任何治疗的人的3.17倍。促排卵药物早产的可能性是对照组的2.17倍。患有女性因素不孕症也与早产的几率更高有关。对于那些怀孕有困难的人来说，尝试较小的侵入性治疗来实现怀孕可能会降低他们早产的风险。网上版载有补充材料，可在10.1186/s12978-022-01363-4查阅。
In vitro fertilization (IVF) births contribute to a considerable proportion of preterm birth (PTB) each year. However, there is no formal surveillance of adverse perinatal outcomes for less invasive fertility treatments. The study objective was to describe associations between fertility treatment (in vitro fertilization, intrauterine insemination, usually with ovulation drugs (IUI), or ovulation drugs alone) and preterm birth, compared to no treatment in subfertile women. The Fertility Experiences Study (FES) is a retrospective cohort study conducted at the University of Utah between April 2010 and September 2012. Women with a history of primary subfertility self-reported treatment data via survey and interviews. Participant data were linked to birth certificates and fetal death records to asses for perinatal outcomes, particularly preterm birth. A total 487 birth certificates and 3 fetal death records were linked as first births for study participants who completed questionnaires. Among linked births, 19% had a PTB. After adjustment for maternal age, paternal age, maternal education, annual income, religious affiliation, female or male fertility diagnosis, and duration of subfertility, the odds ratios and 95% confidence intervals (CI) for PTB were 2.17 (CI 0.99, 4.75) for births conceived using ovulation drugs, 3.17 (CI 1.4, 7.19) for neonates conceived using IUI and 4.24 (CI 2.05, 8.77) for neonates conceived by IVF, compared to women with subfertility who used no treatment during the month of conception. A reported diagnosis of female factor infertility increased the adjusted odds of having a PTB 2.99 (CI 1.5, 5.97). Duration of pregnancy attempt was not independently associated with PTB. In restricting analyses to singleton gestation, odds ratios were not significant for any type of treatment. IVF, IUI, and ovulation drugs were all associated with a higher incidence of preterm birth and low birth weight, predominantly related to multiple gestation births. The online version contains supplementary material available at 10.1186/s12978-022-01363-4. Infertility treatments such as in vitro fertilization are associated with preterm birth, but less is known about how other less invasive treatments contribute to preterm birth. This study compares different types of fertility treatments and rates of preterm birth with women who are also struggling with infertility but did not use fertility treatments at the time of their pregnancy. 490 women were recruited at the University of Utah between 2010 and 2012. Participants were asked to complete a survey and were linked to birth certificate and fetal death certificate data. Women who used in vitro fertilization were 4.24 times more likely to have a preterm birth than those who used no treatment. Use of intrauterine insemination were 3.17 times more likely to have a preterm birth than those who used no treatment at time of conception. Ovulation stimulating drugs were 2.17 times more likely to have a preterm birth. Having female factor infertility was also associated with higher odds of having preterm birth. For those who are having trouble conceiving, trying less invasive treatments to achieve pregnancy might reduce their risk of preterm birth. The online version contains supplementary material available at 10.1186/s12978-022-01363-4.
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DOI：
10.1034/j.1600-0412.2000.079008644.x
发表时间：
2000-08-01
影响因子：
4.3
作者：
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DOI：
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