The Ronald O Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, 1305 York Avenue, 6th Floor New York, New York 10021, USA.
The Ronald O Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, 1305 York Avenue, 6th Floor New York, New York 10021, USA.
Reprod Biomed Online. 2021 Jun;42(6):1181-1186. doi: 10.1016/j.rbmo.2021.01.018. Epub 2021 Jan 30.
Do women of racial minorities aged 40 years or older have similar reproductive and obstetric outcomes as white women undergoing IVF?
A retrospective cohort study conducted at a single academic university-affiliated centre. The study population included women aged 40 years or older undergoing their first IVF cycle with fresh cleavage-stage embryo transfer stratified by racial minority status: minority (black or Asian) versus white. Clinical intrauterine pregnancy and live birth rate were the primary outcomes. Preterm delivery (<37 weeks) and small for gestational age were the secondary outcomes. Odds ratios with 95% confidence intervals were estimated. P < 0.05 was considered to be statistically significant.
A total of 2050 cycles in women over the age of 40 years were analysed, 561 (27.4%) of which were undertaken by minority women and 1489 (72.6%) by white women. Minority women were 30% less likely to achieve a pregnancy compared with their white (non-Hispanic) counterparts (adjusted OR 0.68, CI 0.54 to 0.87). Once pregnant, however, the odds of live birth were similar (adjusted OR 1.23, CI 0.91 to 1.67). Minority women were significantly more likely to have lower gestational ages at time of delivery (38.5 versus 39.2 weeks, P = 0.009) and were more likely to have extreme preterm birth delivery 24-28 weeks (5.5 versus 1.0%, P = 0.021).
Minority women of advanced reproductive age are less likely to achieve a pregnancy compared with white (non-Hispanic) women. Once pregnancy is achieved, however, live birth rates are similar albeit with minority women experiencing higher rates of preterm delivery.
年龄在 40 岁及以上的少数族裔女性接受体外受精（IVF）的生殖和产科结局是否与白人女性相似？
这是一项在单家学术型大学附属中心进行的回顾性队列研究。研究人群包括年龄在 40 岁及以上、接受首次新鲜卵裂期胚胎移植的 IVF 周期的女性，按少数族裔身份分层：少数族裔（黑人或亚裔）与白人。主要结局是临床宫内妊娠和活产率。早产（<37 周）和小于胎龄儿是次要结局。使用 95%置信区间估计比值比。P < 0.05 被认为具有统计学意义。
共分析了 2050 个 40 岁以上女性的周期，其中 561 个（27.4%）由少数族裔女性进行，1489 个（72.6%）由白人女性进行。与白人（非西班牙裔）女性相比，少数族裔女性妊娠的可能性低 30%（调整后的比值比 0.68，95%置信区间 0.54 至 0.87）。然而，一旦怀孕，活产的几率相似（调整后的比值比 1.23，95%置信区间 0.91 至 1.67）。少数族裔女性分娩时的胎龄明显较低（38.5 周与 39.2 周，P = 0.009），而且更有可能在 24-28 周时发生极早产（5.5%与 1.0%，P = 0.021）。
年龄较大的少数族裔女性与白人（非西班牙裔）女性相比，妊娠的可能性较低。然而，一旦怀孕，活产率相似，尽管少数族裔女性的早产率较高。
