Lu Emily, Barfield Wanda D, Wilber Nancy, Diop Hafsatou, Manning Susan E, Fogerty Sally
Bureau of Family and Community Health, Massachusetts Department of Public Health, Boston, MA 02108, USA.
Public Health Rep. 2008 Mar-Apr;123(2):173-7. doi: 10.1177/003335490812300209.
Nationally, infertility therapies (IFTs) are increasingly used to overcome fecundity issues. However, it is unclear to what extent noninvasive IFTs are used compared with assisted reproductive technology. To better understand outcomes related to the increasing use of all types of IFTs, we compared self-reported IFT use from a Massachusetts pilot Pregnancy Risk Assessment Monitoring System (MA-PRAMS) to IFT use recorded on birth certificates (BCs).
In 2005, Massachusetts conducted a three-month pilot study modeled after the Centers for Disease Control and Prevention's PRAMS, a population-based surveillance system that monitors pregnancy experiences. Descriptive and bivariate analyses compared responses to MA-PRAMS survey questions regarding IFT use with data collected on BCs from the same women sampled.
According to MA-PRAMS, 6.1% of live births were conceived using IFTs compared with 3.1% reported on BCs. Reported IFT use varied by maternal age and plurality. For women aged 18-34 years, IFT use reported on MA-PRAMS (5.0%) was 2.5 times higher than that reported on BCs (2.0%). For women aged 35 years or older, reported IFT use was comparable in both systems. For women giving birth to singletons, IFT use reported on MA-PRAMS (5.5%) was three times higher than that reported on BCs (1.8%).
Higher use of IFTs was reported by MA-PRAMS than on BCs, particularly among younger women and those having singleton births. These findings suggest that self-reported IFT use might be a more sensitive method for states to use in assessing population-based IFT usage among women and monitoring trends in adverse birth outcomes.
在全国范围内,不孕治疗(IFTs)越来越多地用于克服生育问题。然而,与辅助生殖技术相比,非侵入性IFTs的使用程度尚不清楚。为了更好地了解与各类IFTs使用增加相关的结果,我们将马萨诸塞州试点妊娠风险评估监测系统(MA-PRAMS)中自我报告的IFT使用情况与出生证明(BCs)上记录的IFT使用情况进行了比较。
2005年,马萨诸塞州开展了一项为期三个月的试点研究,该研究以疾病控制和预防中心的PRAMS为蓝本,PRAMS是一个基于人群的监测系统,用于监测妊娠经历。描述性和双变量分析将MA-PRAMS关于IFT使用的调查问题的回答与从相同抽样女性的BCs上收集的数据进行了比较。
根据MA-PRAMS,6.1%的活产是通过IFTs受孕的,而BCs上报告的这一比例为3.1%。报告的IFT使用情况因产妇年龄和生育数量而异。对于18至34岁的女性,MA-PRAMS报告的IFT使用率(5.0%)是BCs上报告的(2.0%)的2.5倍。对于35岁及以上的女性,两个系统报告的IFT使用率相当。对于生育单胎的女性,MA-PRAMS报告的IFT使用率(5.5%)是BCs上报告的(1.8%)的三倍。
MA-PRAMS报告的IFT使用率高于BCs,特别是在年轻女性和生育单胎的女性中。这些发现表明,自我报告的IFT使用情况可能是各州用于评估女性基于人群的IFT使用情况和监测不良出生结局趋势的更敏感方法。