辅助生殖技术：巴西南部的患病率及相关因素
Assisted reproductive technology: prevalence and associated factors in Southern Brazil.
作者信息
Silva Shana Ginar da, Bertoldi Andréa Dâmaso, Silveira Mariângela Freitas da, Domingues Marlos Rodrigues, Evenson Kelly R, Santos Iná Silva Dos
机构信息
Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
出版信息
Rev Saude Publica. 2019 Jan 31;53:13. doi: 10.11606/S1518-8787.2019053000737.
OBJECTIVE
To assess the prevalence of successful assisted reproductive technology and to identify the associated factors.
METHODS
This population-based birth cohort study was carried out with 4,333 pregnant women expected to deliver in 2015 in the urban area of Pelotas, Southern Brazil. Use of an assisted reproductive technology procedure, type of assisted reproductive technology [in vitro fertilization or intracytoplasmic sperm injection or artificial insemination], number of embryos transferred, success of embryo transfer, number of attempts, and reported reasons for seeking assisted reproductive technology were the main outcomes measured. Use of an assisted reproductive technology procedure was analyzed according to sociodemographic, nutritional, reproductive history, and behavioral characteristics. Unadjusted and adjusted analyses were performed by logistic regression.
RESULTS
Among the 4,275 newborns enrolled in the Pelotas 2015 Birth Cohort Study, 18 births (0.4%) were conceived by assisted reproductive technology. Most cases of assisted reproductive technology were by in vitro fertilization (70.6%). All cycles were performed in private clinics under direct out-of-pocket payment. Even after controlling for confounders, maternal age > 35 years, nulliparity and high family monthly income were strongly associated with assisted reproductive technology.
CONCLUSIONS
The use of assisted reproductive technology services was reported by only a few women in the Pelotas 2015 Birth Cohort Study. Our study highlights sociodemographic factors associated to assisted reproductive technology procedures. To better understand the patterns and barriers in overall use of assisted reproductive technology services over time, national-level trend studies in assisted reproductive technology treatments and outcomes, as well as studies exploring the characteristics of women who have sought this kind of treatment are needed in low-middle income countries.
目的
评估辅助生殖技术成功应用的患病率，并确定相关因素。
方法
本基于人群的出生队列研究在巴西南部佩洛塔斯市区2015年预计分娩的4333名孕妇中开展。主要测量的结果包括辅助生殖技术程序的使用情况、辅助生殖技术的类型（体外受精或卵胞浆内单精子注射或人工授精）、移植胚胎数量、胚胎移植成功率、尝试次数以及寻求辅助生殖技术的报告原因。根据社会人口统计学、营养状况、生殖史和行为特征分析辅助生殖技术程序的使用情况。通过逻辑回归进行未调整和调整分析。
结果
在佩洛塔斯2015年出生队列研究纳入的4275名新生儿中，18例（0.4%）通过辅助生殖技术受孕。大多数辅助生殖技术病例为体外受精（70.6%）。所有周期均在私立诊所进行，费用直接自付。即使在控制混杂因素后，母亲年龄>35岁、未生育和家庭月收入高与辅助生殖技术仍密切相关。
结论
在佩洛塔斯2015年出生队列研究中，只有少数女性报告使用了辅助生殖技术服务。我们的研究突出了与辅助生殖技术程序相关的社会人口统计学因素。为了更好地了解辅助生殖技术服务总体使用随时间的模式和障碍，低收入和中等收入国家需要开展国家级辅助生殖技术治疗及结果的趋势研究，以及探索寻求此类治疗的女性特征的研究。
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