Long term health outcomes for women and their children after assisted reproductive technologies: a data linkage study for England

辅助生殖技术后妇女及其子女的长期健康结果:英格兰的数据关联研究

基本信息

  • 批准号:
    MR/L019671/1
  • 负责人:
  • 金额:
    $ 85.36万
  • 依托单位:
  • 依托单位国家:
    英国
  • 项目类别:
    Fellowship
  • 财政年份:
    2014
  • 资助国家:
    英国
  • 起止时间:
    2014 至 无数据
  • 项目状态:
    已结题

项目摘要

Infertility affects 1 in 7 couples, and the number of babies using Assisted Reproductive Technologies (ART) such as IVF is increasing. Since 1991 over 200,000 children have been born in the UK as a result of ART, which now accounts for about 1-2% of births each year. Most IVF births result in healthy children, but there is good evidence that IVF pregnancies are at higher risk of poor perinatal outcomes (prematurity, low birth weight, a higher incidence of caesarean section), congenital malformations and some rare epigenetic syndromes. Cognitive, developmental and behavioural problems have also been identified, though the evidence is limited and findings are less convincing - in part, because studies in this area are difficult to conduct and sometimes flawed. Higher rates of other adverse outcomes, such as asthma and autism, have also been reported but, again, the evidence is sparse. Studies of health and developmental outcomes of children born after ART tend to focus only on early childhood, so that the long term health and development of ART children is still relatively under-researched. There are also well-recognised risks to the woman at the time of ART treatment, and the negative impact of unsuccessful treatment on women and their partners has been documented. However, when treatment is successful the longer-term implications for the mother are often overlooked. The difficulty of becoming pregnant, perceived high-risk pregnancies and anxiety about birth can all have a lasting impact. The incidence of postnatal depression is higher after ART, and sufferers appear to be more vulnerable to later depressive episodes. Fears about increased cancer risks in women who have undergone treatment appear unfounded, but there remain unanswered questions regarding long-term impacts of ART on maternal physical and mental health, and use of health services. This research seeks to address these issues, and provide evidence for the health and wellbeing of ART mothers and their children in the longer term. The project uses data that is collected by infertility clinics (on behalf of the Human Fertilisation and Embryology Authority) on all ART treatments in the UK since 1991, and links it to GP medical records for the women and their children held in the Clinical Practice Research Datalink mother-baby dataset. It is anticipated that over 280,000 mother-baby pairs will be included, of whom about 4,000 will have been born after ART. The oldest children will have been followed up for over 20 years. We will be exploring the health of children and their mothers using information that is recorded by the doctor or nurse practitioner when they visit their doctor's surgery, such as diagnoses of medical conditions, prescriptions for medication and referrals for specialist treatment. The increased use of health services, if any, among ART mother-baby pairs will also be assessed. Currently the HFEA seeks consent from all couples undergoing ART to allow scientists to use their data in research, but less than half agree. Another aspect of this project will be to assess the effect of this low participation rate on the results of research using the HFEA data, and to explore ways that the effects of missing data can be reduced or removed. These projects all use routine data, but we will also be conducting a study that recruits couples undergoing treatment and explores why they choose to give, or to refuse, consent for research. The aim of this part of the study is to provide information to try and help increase consent rates in the future. The research will be led by Claire Carson, an epidemiologist at the National Perinatal Epidemiology Unit, University of Oxford, who will be working with specialists in perinatal and maternal epidemiology (Jennifer Kurinczuk, Maria Quigley, Alistair Sutcliffe), qualitative research methods (Lisa Hinton), health economics (Oliver Riviera-Arias) and the management of missing data (Mike Kenward).
不孕症影响七分之一的夫妇,使用辅助生殖技术(ART)如IVF的婴儿数量正在增加。自1991年以来,联合王国有20多万儿童因抗逆转录病毒疗法而出生,现在约占每年出生人数的1-2%。大多数试管婴儿都能生出健康的孩子,但有充分的证据表明,试管婴儿怀孕的围产期结局(早产,低出生体重,剖腹产发生率较高),先天性畸形和一些罕见的表观遗传综合征的风险较高。认知、发展和行为问题也被发现,尽管证据有限,调查结果也不太令人信服-部分原因是这方面的研究难以进行,有时还存在缺陷。其他不良后果的发生率较高,如哮喘和自闭症,也有报道,但同样,证据不足。对ART后出生的儿童的健康和发育结果的研究往往只关注幼儿期,因此ART儿童的长期健康和发育仍然相对不足。在接受抗逆转录病毒疗法治疗时,妇女也面临公认的风险,治疗不成功对妇女及其伴侣的负面影响也有记录。然而,当治疗成功时,对母亲的长期影响往往被忽视。怀孕的困难,认为高风险怀孕和对分娩的焦虑都可能产生持久的影响。ART后产后抑郁症的发病率更高,患者似乎更容易受到后期抑郁发作的影响。对接受过治疗的妇女患癌症风险增加的担心似乎没有根据,但关于抗逆转录病毒疗法对孕产妇身心健康的长期影响以及保健服务的使用情况,仍然存在未解之谜。这项研究旨在解决这些问题,并为ART母亲及其子女的长期健康和福祉提供证据。该项目使用不孕症诊所(代表人类受精和胚胎学管理局)自1991年以来在英国收集的所有ART治疗的数据,并将其与临床实践研究Datalink母婴数据集中的妇女及其子女的GP医疗记录联系起来。预计将包括280 000对母婴,其中约4 000对将在抗逆转录病毒疗法后出生,年龄最大的儿童将接受20多年的随访。我们将利用医生或执业护士在他们去看医生手术时记录的信息,如医疗条件诊断、药物处方和专科治疗转诊,来探索儿童及其母亲的健康状况。还将评估抗逆转录病毒疗法母婴对中增加使用保健服务的情况。目前,HFEA寻求所有接受ART的夫妇的同意,允许科学家在研究中使用他们的数据,但只有不到一半的人同意。该项目的另一个方面将是评估这种低参与率对使用HFEA数据的研究结果的影响,并探索减少或消除缺失数据影响的方法。这些项目都使用常规数据,但我们也将进行一项研究,招募正在接受治疗的夫妇,并探讨他们为什么选择同意或拒绝同意研究。这部分研究的目的是提供信息,以帮助提高未来的同意率。该研究将由牛津大学国家围产期流行病学单位的流行病学家Claire卡森领导,他将与围产期和孕产妇流行病学(Jennifer Kurinczuk,Maria Quigley,Alistair Sutcliffe),定性研究方法(丽莎欣顿),卫生经济学(奥利弗Riviera-Arias)和缺失数据管理(Mike Kenward)的专家合作。

项目成果

期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Long-term healthcare utilization and costs of babies born after assisted reproductive technologies (ART): a record linkage study with 10-years' follow-up in England.
辅助生殖技术(ART)出生的长期医疗保健利用和成本:一项创纪录的联系研究,并在英格兰进行了10年的随访。
Unplanned pregnancy and subsequent psychological distress in partnered women: a cross-sectional study of the role of relationship quality and wider social support.
合作妇女的计划外怀孕和随后的心理困扰:对关系质量和更广泛的社会支持的作用的横断面研究。
  • DOI:
    10.1186/s12884-017-1223-x
  • 发表时间:
    2017-01-26
  • 期刊:
  • 影响因子:
    3.1
  • 作者:
    Barton K;Redshaw M;Quigley MA;Carson C
  • 通讯作者:
    Carson C
OP13 The changing prevalence of births after subfertility and fertility treatment in england 1991-2013: evidence from the clinical practice research datalink
OP13 1991-2013 年英国生育力低下和生育治疗后出生率的变化:来自临床实践研究数据链的证据
  • DOI:
    10.1136/jech-2017-ssmabstracts.13
  • 发表时间:
    2017
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Carson C
  • 通讯作者:
    Carson C
The association between conception history and subsequent postpartum depression and/or anxiety: Evidence from the Clinical Practice Research Datalink 1991-2013.
受孕史与随后的产后抑郁和/或焦虑之间的关联:来自 1991-2013 年临床实践研究数据链的证据。
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Claire Carson其他文献

Infertility among male UK veterans of the 1990-1 Gulf war: reproductive cohort study
1990-1 海湾战争英国男性退伍军人的不孕症:生殖队列研究
  • DOI:
  • 发表时间:
    2004
  • 期刊:
  • 影响因子:
    0
  • 作者:
    N. Maconochie;P. Doyle;Claire Carson
  • 通讯作者:
    Claire Carson
How women with obsessive compulsive disorder experience maternity care and mental health care during pregnancy and postpartum: A systematic literature review
  • DOI:
    10.1016/j.jad.2022.06.041
  • 发表时间:
    2022-10-01
  • 期刊:
  • 影响因子:
    4.900
  • 作者:
    Hollie A.L. Burton;Luise Pickenhan;Claire Carson;Paul Salkovskis;Fiona Alderdice
  • 通讯作者:
    Fiona Alderdice
Pre-pregnancy care in general practice in England: cross-sectional observational study using administrative routine health data
  • DOI:
    10.1186/s12889-025-21728-1
  • 发表时间:
    2025-03-22
  • 期刊:
  • 影响因子:
    3.600
  • 作者:
    Yangmei Li;Jennifer J. Kurinczuk;Fiona Alderdice;Maria A. Quigley;Oliver Rivero-Arias;Julia Sanders;Sara Kenyon;Dimitrios Siassakos;Nikesh Parekh;Suresha De Almeida;Claire Carson
  • 通讯作者:
    Claire Carson

Claire Carson的其他文献

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{{ truncateString('Claire Carson', 18)}}的其他基金

MRC Transition Support Award: Long-term health outcomes for women & their children after assisted reproductive technologies: a data linkage study
MRC 转型支持奖:女性的长期健康成果
  • 批准号:
    MR/W029286/1
  • 财政年份:
    2022
  • 资助金额:
    $ 85.36万
  • 项目类别:
    Fellowship

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