Koivurova Sari, Hartikainen Anna-Liisa, Gissler Mika, Hemminki Elina, Järvelin Marjo-Riitta
Department of Obstetrics and Gynecology, University Hospital of Oulu, 90029 Oulu, Finland.
Hum Reprod. 2007 Aug;22(8):2136-41. doi: 10.1093/humrep/dem150. Epub 2007 Jun 21.
The objective of this study was to evaluate whether the post-neonatal hospitalization and resulting health care costs are increased among in vitro fertilization (IVF) children up to 7 years of age.
We conducted a population-based cohort study with linkage to a national hospital discharge register including 303 IVF children, born from 1990 to 1995, and 567 control children (1:2) randomly chosen from the Finnish Medical Birth Register and matched for sex, year of birth, area of residence, parity, maternal age and socioeconomic status. The cost calculations were stratified for singleton (n = 152 vs. n = 285) and twin (n = 103 vs. n = 103) status. Main outcome measures were hospitalizations and societal health care costs.
The full-sample and singleton analyses showed that IVF children were significantly more frequently admitted to hospital (mean 1.76 vs. 1.07, P < 0.0001; 1.61 vs. 1.07, P = 0.0004, respectively) and spent significantly more days in the hospital (mean 4.31 vs. 2.61, P < 0.0001; 3.47 vs. 2.56, P = 0.0014, respectively) than control children. No differences were detected between IVF and control twins. The costs of post-neonatal hospital care per child were 2.6-fold for IVF singletons, but 0.7-fold for IVF twins when compared with controls. Cost estimation showed 2.6-fold costs for total IVF population in comparison to general population based controls.
The incidence of multiple births increases the utilization of post-neonatal health care services and costs among IVF children in comparison to naturally conceived children. Increased hospitalization and costs were also seen among IVF singletons.
本研究的目的是评估7岁以下体外受精（IVF）儿童的新生儿后期住院情况及由此产生的医疗保健费用是否增加。
我们进行了一项基于人群的队列研究，该研究与国家医院出院登记册相关联，纳入了1990年至1995年出生的303名IVF儿童，以及从芬兰医学出生登记册中随机选取的567名对照儿童（1:2），并按照性别、出生年份、居住地区、产次、母亲年龄和社会经济地位进行匹配。成本计算按单胎（n = 152对n = 285）和双胎（n = 103对n = 103）状态进行分层。主要结局指标为住院情况和社会医疗保健费用。
全样本和单胎分析显示，IVF儿童入院频率显著高于对照儿童（平均1.76次对1.07次，P < 0.0001；1.61次对1.07次，P = 0.0004），且住院天数显著更多（平均4.31天对2.61天，P < 0.0001；3.47天对2.56天，P = 0.0014）。未发现IVF儿童与对照双胎之间存在差异。与对照相比，IVF单胎儿童的新生儿后期住院护理费用是对照的2.6倍，但IVF双胎儿童的费用是对照的0.7倍。成本估算显示，与基于普通人群的对照相比，IVF总体人群的成本是其2.6倍。
与自然受孕儿童相比，多胎出生率增加了IVF儿童对新生儿后期医疗保健服务的利用和费用。IVF单胎儿童的住院率和费用也有所增加。
