Farr Sherry L, Schieve Laura A, Jamieson Denise J
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Am J Epidemiol. 2007 Jun 15;165(12):1380-8. doi: 10.1093/aje/kwm035. Epub 2007 Mar 10.
Approximately 30% of pregnancies in the United States may end in miscarriage or stillbirth. Whether pregnancies conceived through assisted reproductive technology (ART) are at an increased risk of loss is inconclusive, and data on maternal age-, ART type-, and gestational age-specific risk of loss are limited. Data on 148,494 ART pregnancies conceived from 1999 through 2002 were analyzed by use of the Kaplan-Meier method to estimate risks of pregnancy loss after specified gestational ages (conditional risk) for 14 groups stratified by maternal age and ART procedure. Births, maternal deaths, and induced abortions were censored. The Kaplan-Meier estimate of total risk of pregnancy loss was 29% but ranged from 22% to 63% depending on patient age and ART procedure. By 6 weeks' gestation, 58% of all pregnancy losses occurred. Conditional risk of pregnancy loss ranged from 10% to 45% at 6 weeks' gestation and from 2% to 7% at the first trimester; it was less than 2% after 20 weeks' gestation. Results can be used to counsel ART patients and inform future research on the etiology of pregnancy loss.
在美国，约30%的妊娠可能以流产或死产告终。通过辅助生殖技术（ART）受孕的妊娠丢失风险是否增加尚无定论，且关于产妇年龄、ART类型和特定孕周的妊娠丢失风险的数据有限。采用Kaplan-Meier方法分析了1999年至2002年期间148494例ART妊娠的数据，以估计按产妇年龄和ART程序分层的14组在特定孕周后的妊娠丢失风险（条件风险）。出生、孕产妇死亡和人工流产被视为删失数据。Kaplan-Meier估计的妊娠丢失总风险为29%，但根据患者年龄和ART程序的不同，范围在22%至63%之间。到妊娠6周时，所有妊娠丢失中有58%发生。妊娠6周时的妊娠丢失条件风险在10%至45%之间，孕早期在2%至7%之间；妊娠20周后小于2%。研究结果可用于为ART患者提供咨询，并为未来关于妊娠丢失病因的研究提供参考。
