Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, British Columbia, Canada.
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Paediatr Perinat Epidemiol. 2023 Feb;37(2):117-127. doi: 10.1111/ppe.12925. Epub 2022 Aug 29.
The initial COVID-19 pandemic response-related effects on conceptions following the use of assisted reproductive technologies (ART), and on changes in the maternal characteristics of women who conceived during the early vs. pre-pandemic period, have been understudied.
To examine the effects of ART clinic closures in the United States (US) in March 2020 on the frequency of ART-conceived live births, multiple births and stillbirths; and to describe changes in the characteristics of women who conceived in the early pandemic period.
Population-based cohort study including all births in the US from January 2015 to December 2020 (22,907,688 live births; 134,537 stillbirths). Interrupted time series (ITS) methodology was used to estimate rate ratios (RR) of expected versus observed rates in December 2020 (i.e., among births conceived mainly in March 2020). Demographic and clinical characteristics were compared between mothers who conceived in March 2020 versus March 2015-2019.
Overall, 1.1% of live births and 1.7% of stillbirths were conceived by ART. ART-conceived live births decreased by 57.0% in December 2020 (observed vs. expected RR 0.43, 95% confidence interval [CI] 0.40, 0.45), and these declines occurred in all subgroups of women. Multiple births also declined in December 2020. Stillbirth rates increased in December 2020 in ART-conceived births (RR 2.55, 95% CI 1.63, 3.92) but remained unchanged in the non-ART group. Maternal characteristics of women who conceived in the early pandemic versus pre-pandemic period differed and included an increased prevalence of pre-pregnancy obesity class 3 and chronic hypertension.
The early pandemic closure of ART clinics resulted in a substantial decline in ART-conceived live births and multiple births in December 2020 and an increase in the proportion of stillbirths among ART-conceived births. Women who conceived in the early pandemic period also had an increased prevalence of obesity and chronic hypertension.
对于辅助生殖技术（ART）使用后受孕的概念以及在大流行早期与大流行前相比受孕的女性的母体特征的变化，有关 COVID-19 大流行初期相关反应的研究还很不足。
研究美国（US）2020 年 3 月 ART 诊所关闭对 ART 受孕活产、多胎和死胎频率的影响；并描述大流行早期受孕女性特征的变化。
这是一项包括 2015 年 1 月至 2020 年 12 月美国所有活产（22907688 例活产；134537 例死产）的基于人群的队列研究。采用中断时间序列（ITS）方法估计 2020 年 12 月（即主要在 2020 年 3 月受孕的分娩）预期与观察率的比率比（RR）。比较 2020 年 3 月与 2015-2019 年 3 月受孕的母亲的人口统计学和临床特征。
总体而言，1.1%的活产和 1.7%的死产是通过 ART 受孕的。2020 年 12 月，ART 受孕的活产下降了 57.0%（观察 RR 0.43，95%CI 0.40，0.45），所有亚组的妇女均出现下降。多胎分娩在 2020 年 12 月也有所下降。2020 年 12 月，ART 受孕的死产率上升（RR 2.55，95%CI 1.63，3.92），而非 ART 组则保持不变。与大流行前相比，大流行早期受孕的妇女的母体特征存在差异，包括孕前肥胖 3 级和慢性高血压的发生率增加。
ART 诊所的早期大流行关闭导致 2020 年 12 月 ART 受孕活产和多胎分娩大幅下降，ART 受孕分娩的死产比例增加。大流行早期受孕的妇女肥胖和慢性高血压的患病率也有所增加。
