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在试图怀孕并经历活产的女性中,与妊娠尝试持续时间相关的生育治疗的使用情况。

Use of fertility treatments in relation to the duration of pregnancy attempt among women who were trying to become pregnant and experienced a live birth.

机构信息

Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT, 84108, USA.

Utah Department of Health, Cannon Health Building, 288 North 1460 West, Salt Lake City, UT, 84116, USA.

出版信息

Matern Child Health J. 2014 Jan;18(1):258-267. doi: 10.1007/s10995-013-1262-5.

Abstract

The purpose of this study was to compare the utilization of medical help for fertility among women who reported up to a year versus more than a year of trying to become pregnant and to describe the characteristics of those women seeking early treatment. Data from the 2004-2008 Pregnancy Risk Assessment Monitoring System (PRAMS) survey were used to assess attempt duration and use of fertility treatments in a sample of 9,517 women who had a recent live birth in Utah. PRAMS respondents who were trying to become pregnant at the time of conception were asked questions about fertility treatments (sampling n = 5,238; representative n = 153,036). Univariate and bivariate analyses were used to describe and compare characteristics of women who sought treatment after attempting pregnancy for a year or less and women who waited at least a year to seek treatment. Among women who were trying to become pregnant, 9.5 % reported using some medical assistance to conceive. Among the women trying to become pregnant, 89.3 % had been trying for ≤12 months and 10.7 % reported having tried >12 months. 5.2 % of those trying to become pregnant for up to a year reported use of fertility treatment, compared with 45.8 % of those trying for a year or more. Women who had previous live births were significantly more likely to use early treatment than nulliparous women (aOR = 2.4, 95 % CI = 1.5, 3.9). The use of fertility drugs and other treatments were more common than ART among recipients of early treatment (aOR = 3.7, 95 % CI = 1.7, 7.9). Some women may be receiving fertility treatment before it is clinically indicated. Instead of invasive treatment, these women may benefit from preconception counseling on folic acid, healthy prepregnancy weight and use of ovulation monitoring to time intercourse.

摘要

本研究旨在比较报告尝试怀孕时间为一年或一年以下和一年以上的女性对生育的医疗帮助的利用情况,并描述那些寻求早期治疗的女性的特征。本研究使用了 2004-2008 年犹他州妊娠风险评估监测系统(PRAMS)调查的数据,对最近分娩的 9517 名女性样本中尝试怀孕的时间和生育治疗的使用情况进行评估。在受孕时正在尝试怀孕的 PRAMS 受访者被问及生育治疗的问题(抽样 n=5238;代表性 n=153036)。采用单变量和双变量分析来描述和比较在尝试怀孕一年或更短时间后寻求治疗的女性和至少等待一年后寻求治疗的女性的特征。在试图怀孕的女性中,有 9.5%报告使用了一些医疗辅助手段来怀孕。在试图怀孕的女性中,89.3%的人尝试怀孕时间≤12 个月,10.7%的人尝试怀孕时间>12 个月。在尝试怀孕时间不超过一年的女性中,有 5.2%报告使用了生育治疗,而在尝试怀孕一年或更长时间的女性中,这一比例为 45.8%。有先前活产史的女性比初产妇更有可能进行早期治疗(调整后的比值比[aOR]=2.4,95%置信区间[CI]=1.5,3.9)。在接受早期治疗的人群中,生育药物和其他治疗的使用比 ART 更为常见(aOR=3.7,95%CI=1.7,7.9)。一些女性可能在临床指征之前就开始接受生育治疗。这些女性可能受益于孕前咨询,包括叶酸、健康的孕前体重和使用排卵监测来安排性行为,而不是接受侵入性治疗。

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