Section of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, College of Medicine, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma.
Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma.
Paediatr Perinat Epidemiol. 2019 Mar;33(2):119-125. doi: 10.1111/ppe.12538. Epub 2019 Jan 31.
The prevalence of infertility in American Indian/Alaska Native (AI/AN) populations is unknown. The objective of our study was to estimate the prevalence of infertility and impaired fecundity in the AI/AN population and other racial and ethnic groups.
We analyzed female respondent data from the pooled National Survey of Family Growth (NSFG) cycles 2002, 2006-2010, and 2011-2013. We used modified Poisson regression with robust error variance accounting for survey weighting to estimate prevalence proportion ratios (PPR) and 95% confidence intervals (CI) for NSFG definitions of infertility and impaired fecundity by race and Hispanic ethnicity.
The prevalence of infertility and impaired fecundity in the pooled NSFG was 6.4% (95% CI 5.7, 7.0) and 11.0% (95% CI 11.0, 12.2), respectively. Compared to whites, blacks had a 1.45 times greater adjusted prevalence of infertility (95% CI 1.15, 1.83) and AI/ANs had a 1.37 times greater prevalence of infertility (95% CI 0.91, 2.06) compared to whites. We observed a 1.30 times greater prevalence of impaired fecundity among AI/AN (95% CI 1.04, 1.62) compared to whites. We observed no differences in impaired fecundity for black or Asian/Pacific Islander women compared to whites or for Hispanic compared to non-Hispanic women.
Inequalities in the burden of reproductive impairments among blacks and AI/AN women warrant further evaluation to identify opportunities for prevention and disparity reduction.
美国印第安人/阿拉斯加原住民(AI/AN)人群中的不孕不育患病率尚不清楚。本研究的目的是估计 AI/AN 人群及其他种族和族裔群体的不孕不育和生育力受损的患病率。
我们分析了汇总后的 2002 年、2006-2010 年和 2011-2013 年全国家庭增长调查(NSFG)周期中女性应答者的数据。我们使用改良泊松回归模型和稳健误差方差,考虑了调查权重,来估计 NSFG 对不孕不育和生育力受损的定义在不同种族和西班牙裔中的患病率比例(PPR)和 95%置信区间(CI)。
汇总后的 NSFG 中不孕不育和生育力受损的患病率分别为 6.4%(95%CI 5.7,7.0)和 11.0%(95%CI 11.0,12.2)。与白人相比,黑人调整后的不孕不育患病率高出 1.45 倍(95%CI 1.15,1.83),而 AI/AN 则高出 1.37 倍(95%CI 0.91,2.06)。与白人相比,我们观察到 AI/AN 生育力受损的患病率高出 1.30 倍(95%CI 1.04,1.62)。与白人相比,我们未观察到黑人或亚洲/太平洋岛民女性的生育力受损患病率有差异,或西班牙裔与非西班牙裔女性的生育力受损患病率有差异。
黑人和 AI/AN 女性在生殖障碍负担方面的不平等现象值得进一步评估,以确定预防和减少差异的机会。