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美国因辅助生殖技术而导致的多胎妊娠所致的早产:成本分析。

Preterm deliveries that result from multiple pregnancies associated with assisted reproductive technologies in the USA: a cost analysis.

机构信息

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA.

出版信息

Curr Opin Obstet Gynecol. 2011 Jun;23(3):168-73. doi: 10.1097/GCO.0b013e32834551cd.

Abstract

PURPOSE OF REVIEW

Simultaneous transfer of multiple embryos in an assisted reproductive technology (ART) cycle results in a high rate of multiple pregnancy. Besides the medical complications associated with multiple pregnancy, the financial burden of the resultant preterm infants is also substantial. The current review evaluates the costs associated with the care of preterm infants that are born as a result of ART-associated multiple pregnancies.

RECENT FINDINGS

In 2006, 30% of all ART live births were multiple infant deliveries in the USA. This resulted in 48% of all ART neonates being the product of a multiple infant delivery. In the same year, 62% of ART twins and 97% of ART triplets were delivered preterm, corresponding to approximately 17 000 infants. The Board of Health Sciences Policy has estimated the mean cost of each preterm infant to be US$ 51 600. Therefore, the financial burden of ART-associated preterm deliveries is estimated to be approximately US$ 1 billion annually. This figure has remained essentially unchanged between 2001 and 2006, despite decreasing number of embryos transferred, due to increasing total number of ART cycles performed.

SUMMARY

Preterm deliveries that result from ART-associated multiple pregnancies add a substantial burden to overall US healthcare expenditure annually. Policies limiting the number of embryos transferred should be considered with a perspective to increase elective single embryo transfers.

摘要

目的综述

辅助生殖技术(ART)周期中同时移植多个胚胎会导致多胎妊娠的发生率很高。除了多胎妊娠相关的医学并发症外,由此导致的早产儿的经济负担也相当大。本次综述评估了与 ART 相关的多胎妊娠所导致的早产儿护理相关的费用。

最近的发现

2006 年,美国所有接受 ART 的活产儿中有 30%是多胎分娩,这导致所有接受 ART 的新生儿中有 48%是多胎分娩的产物。同年,62%的 ART 双胞胎和 97%的 ART 三胞胎早产,约有 17000 名婴儿。健康科学政策委员会估计每个早产儿的平均成本为 51600 美元。因此,ART 相关早产分娩的经济负担估计每年约为 10 亿美元。尽管胚胎移植数量减少,但由于 ART 周期总数的增加,这一数字在 2001 年至 2006 年间基本保持不变。

总结

ART 相关多胎妊娠导致的早产儿分娩每年给美国整体医疗保健支出带来了巨大负担。应考虑限制胚胎移植数量的政策,以增加选择性单胚胎移植。

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