The Association Between Infertility Treatment and Birth Outcomes for Nulliparous Persons Who Gave Birth 35 Years and Older: Findings from 2022 National Vital Statistics System Natality Data.

IF 1.7 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Maternal and Child Health Journal Pub Date : 2025-10-01 Epub Date: 2025-09-01 DOI:10.1007/s10995-025-04174-8

Shanti U Gallivan, Lynn M Yee, Alexa Freedman, Joe Feinglass

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引用次数: 0

Abstract

Objectives: This study uses 2022 National Vital Statistics System natality data to identify characteristics associated with infertility treatment among nulliparous individuals 35 years or older, comparing pregnancy and birth outcomes between no infertility treatment and assisted reproductive technology (ART) or fertility-enhancing drugs or intrauterine insemination (IUI).

Methods: The likelihood of infertility treatment was estimated after controlling for maternal age, education, race and ethnicity, insurance status, Women, Infants and Children (WIC) support, pre-pregnancy body mass index (BMI), chronic hypertension, diabetes, and smoking during pregnancy. Maternal outcomes (gestational diabetes, hypertensive disorders of pregnancy, cesarean birth, maternal morbidity) and neonatal outcomes (preterm birth, low birth weight, neonatal intensive care, and congenital anomalies) were compared for singleton and multifetal births separately.

Results: Among 173,399 births, 13.6% had infertility treatment (10.9% ART, 2.4% IUI). As compared to people who identified as white or Asian, infertility treatment was over one-third less likely for non-Hispanic Black and Hispanic individuals and 2.4 times more likely for those with a graduate degree as compared to those with less than high school. Infertility treatment was associated with significantly higher rates of all adverse maternal and neonatal outcomes, and among multifetal births, ART was associated with a higher rate of maternal morbidity and more frequent gestational diabetes.

Conclusions for practice: Disparities in infertility treatment exist. ART was associated with modest but significantly worse outcomes, particularly for singleton births. Continued monitoring of infertility treatment selection and birth outcomes is needed for informed clinical and public policy decisions.

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35岁及以上未生育人群不孕治疗与生育结局之间的关系：来自2022年国家生命统计系统出生数据的发现

目的：本研究使用2022年国家生命统计系统出生数据，以确定35岁或以上未生育个体的不孕症治疗相关特征，比较未接受不孕症治疗与辅助生殖技术（ART）或生育增强药物或宫内人工授精（IUI）的妊娠和分娩结局。方法：在控制产妇年龄、受教育程度、种族和民族、保险状况、妇女、婴儿和儿童（WIC）支持、孕前体重指数（BMI）、慢性高血压、糖尿病和怀孕期间吸烟等因素后，估计不孕不育治疗的可能性。分别比较单胎和多胎分娩的孕产妇结局（妊娠期糖尿病、妊娠高血压疾病、剖宫产、孕产妇发病率）和新生儿结局（早产、低出生体重、新生儿重症监护和先天性异常）。结果：在173399例新生儿中，13.6%接受了不孕治疗（ART 10.9%, IUI 2.4%）。与白人或亚洲人相比，非西班牙裔黑人和西班牙裔人接受不孕症治疗的可能性要低三分之一以上，而拥有研究生学历的人接受不孕症治疗的可能性是高中以下学历的人的2.4倍。不孕症治疗与所有不良孕产妇和新生儿结局的发生率显著升高相关，在多胎分娩中，抗逆转录病毒治疗与较高的孕产妇发病率和更频繁的妊娠糖尿病相关。实践结论：不孕症治疗存在差异。抗逆转录病毒治疗与适度但明显较差的结果相关，尤其是单胎分娩。需要继续监测不孕症治疗选择和生育结果，以便作出知情的临床和公共政策决定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Maternal and Child Health Journal PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

3.20

自引率

4.30%

发文量

271

期刊介绍： Maternal and Child Health Journal is the first exclusive forum to advance the scientific and professional knowledge base of the maternal and child health (MCH) field. This bimonthly provides peer-reviewed papers addressing the following areas of MCH practice, policy, and research: MCH epidemiology, demography, and health status assessment Innovative MCH service initiatives Implementation of MCH programs MCH policy analysis and advocacy MCH professional development. Exploring the full spectrum of the MCH field, Maternal and Child Health Journal is an important tool for practitioners as well as academics in public health, obstetrics, gynecology, prenatal medicine, pediatrics, and neonatology. Sponsors include the Association of Maternal and Child Health Programs (AMCHP), the Association of Teachers of Maternal and Child Health (ATMCH), and CityMatCH.