Johnson Blair, Chavkin Wendy
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia Presbyterian Medical Center, 622 W. 168th Street, PH-16, New York, NY 10032, USA.
Matern Child Health J. 2007 May;11(3):219-25. doi: 10.1007/s10995-006-0160-5. Epub 2006 Oct 25.
At 12.5%, the preterm birth rate is the highest it has ever been in the US. In tandem with the rise in preterm birth is a dramatic increase in multiple birth rates. The recent trend of delayed maternal age at first birth and the associated use of assisted reproductive technologies (ARTs) have led to the increase in multiple gestation and its attendant increased risk for preterm birth. While ARTs are not responsible for the majority of preterm births, the attributable fraction has increased, is iatrogenic- and preventable. Despite widespread recognition of this problem, the rate of associated twin gestation has not decreased. We offer options for policymakers on several levels--from medical to health systems to societal policy--to decrease ART-related preterm births.
美国的早产率为12.5%，是有史以来的最高水平。与早产率上升相伴的是多胞胎出生率的急剧增加。首次生育时产妇年龄推迟的近期趋势以及辅助生殖技术（ART）的相关使用导致了多胎妊娠的增加及其随之而来的早产风险增加。虽然辅助生殖技术并非大多数早产的原因，但可归因比例有所增加，且是医源性的、可预防的。尽管对这一问题已广泛认识，但相关双胎妊娠率并未下降。我们为政策制定者提供了几个层面的选择——从医疗层面到卫生系统层面再到社会政策层面——以减少与辅助生殖技术相关的早产。
