Linn E Moore, Morteza Haijhosseini, Tarek Motan, Padma Kaul
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We also compared maternal characteristics and perinatal outcomes of AHR and non-AHR pregnancies, and by maternal age group.</p><p><strong>Results: </strong>Of 518 293 live births during the study period, 26 270 (5.1%) were conceived with AHR. The incidence of AHR pregnancies increased from 30.8 per 1000 pregnancies in 2009 to 54.7 per 1000 pregnancies in 2018. Females who used AHR were older (33.9 yr v. 30.1 yr, <i>p</i> < 0.001) and the number of females aged 30-35 years and older than 35 years who delivered following AHR increased over the study period (30-35 yr: 36.9 to 55.3 per 1000 pregnancies; > 35 yr: 79.1 to 95.2 per 1000 pregnancies). The proportion of live births with cesarean delivery (40.5% v. 23.3%, <i>p</i> < 0.001), low birth weight (26.9% v. 7.6%, <i>p</i> < 0.001), congenital malformation (0.5% v. 0.3%, <i>p</i> = 0.002) and admission to the neonatal intensive care unit (25.3% v. 9.7%, <i>p</i> < 0.001) was higher in the AHR group than the non-AHR group.</p><p><strong>Interpretation: </strong>The incidence of live births following AHR pregnancies in Alberta was 5.1% between 2009 and 2018, and increased by 0.26% per year; newborns in the AHR group appeared smaller and showed signs of poorer health. 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We sought to describe trends in pregnancies using AHR and to evaluate the impact of AHR on perinatal outcomes in a large population-based cohort in Alberta, Canada.</p><p><strong>Methods: </strong>We linked maternal and child administrative data for all live births occurring July 1, 2009, to Dec. 31, 2018, in Alberta, Canada, for this retrospective study. We identified AHR pregnancies from pharmaceutical claims or codes from the <i>International Classification of Diseases and Related Health Problems</i> (9th or 10th revision). Our main outcome measures were the incidence and temporal trends of live births in AHR pregnancies. We also compared maternal characteristics and perinatal outcomes of AHR and non-AHR pregnancies, and by maternal age group.</p><p><strong>Results: </strong>Of 518 293 live births during the study period, 26 270 (5.1%) were conceived with AHR. The incidence of AHR pregnancies increased from 30.8 per 1000 pregnancies in 2009 to 54.7 per 1000 pregnancies in 2018. Females who used AHR were older (33.9 yr v. 30.1 yr, <i>p</i> < 0.001) and the number of females aged 30-35 years and older than 35 years who delivered following AHR increased over the study period (30-35 yr: 36.9 to 55.3 per 1000 pregnancies; > 35 yr: 79.1 to 95.2 per 1000 pregnancies). The proportion of live births with cesarean delivery (40.5% v. 23.3%, <i>p</i> < 0.001), low birth weight (26.9% v. 7.6%, <i>p</i> < 0.001), congenital malformation (0.5% v. 0.3%, <i>p</i> = 0.002) and admission to the neonatal intensive care unit (25.3% v. 9.7%, <i>p</i> < 0.001) was higher in the AHR group than the non-AHR group.</p><p><strong>Interpretation: </strong>The incidence of live births following AHR pregnancies in Alberta was 5.1% between 2009 and 2018, and increased by 0.26% per year; newborns in the AHR group appeared smaller and showed signs of poorer health. 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引用次数: 0
摘要
背景:辅助人类生殖(AHR)可用于帮助个人和夫妇克服不孕症问题。我们试图用AHR描述妊娠趋势，并评估AHR对加拿大艾伯塔省一个大型人群队列的围产期结局的影响。方法:我们将加拿大阿尔伯塔省2009年7月1日至2018年12月31日所有活产的母婴管理数据进行了回顾性研究。我们从《国际疾病和相关健康问题分类》(第9版或第10版)的药品声明或代码中确定了AHR妊娠。我们的主要结局指标是AHR妊娠中活产的发生率和时间趋势。我们还比较了AHR和非AHR妊娠的产妇特征和围产期结局，并按产妇年龄组进行了比较。结果:在研究期间的518293例活产婴儿中，26 270例(5.1%)为AHR。AHR妊娠的发生率从2009年的30.8‰上升到2018年的54.7‰。使用AHR的女性年龄较大(33.9岁vs . 30.1岁，p < 0.001)，年龄在30-35岁及35岁以上的女性在AHR后分娩的人数在研究期间有所增加(30-35岁:36.9至55.3‰;> 35岁:79.1 - 95.2 / 1000)。AHR组剖宫产(40.5% vs . 23.3%， p < 0.001)、低出生体重(26.9% vs . 7.6%， p < 0.001)、先天性畸形(0.5% vs . 0.3%， p = 0.002)和新生儿重症监护病房住院(25.3% vs . 9.7%， p < 0.001)的活产比例高于非AHR组。解释:2009年至2018年，阿尔伯塔省AHR妊娠后的活产率为5.1%，每年增长0.26%;AHR组的新生儿看起来更小，健康状况也更差。本研究提供了AHR后潜在围产期并发症的见解，这在照顾新生儿时可能是重要的。
Assisted human reproduction and pregnancy outcomes in Alberta, 2009-2018: a population-based study.
Background: Assisted human reproduction (AHR) can be used to help individuals and couples overcome infertility issues. We sought to describe trends in pregnancies using AHR and to evaluate the impact of AHR on perinatal outcomes in a large population-based cohort in Alberta, Canada.
Methods: We linked maternal and child administrative data for all live births occurring July 1, 2009, to Dec. 31, 2018, in Alberta, Canada, for this retrospective study. We identified AHR pregnancies from pharmaceutical claims or codes from the International Classification of Diseases and Related Health Problems (9th or 10th revision). Our main outcome measures were the incidence and temporal trends of live births in AHR pregnancies. We also compared maternal characteristics and perinatal outcomes of AHR and non-AHR pregnancies, and by maternal age group.
Results: Of 518 293 live births during the study period, 26 270 (5.1%) were conceived with AHR. The incidence of AHR pregnancies increased from 30.8 per 1000 pregnancies in 2009 to 54.7 per 1000 pregnancies in 2018. Females who used AHR were older (33.9 yr v. 30.1 yr, p < 0.001) and the number of females aged 30-35 years and older than 35 years who delivered following AHR increased over the study period (30-35 yr: 36.9 to 55.3 per 1000 pregnancies; > 35 yr: 79.1 to 95.2 per 1000 pregnancies). The proportion of live births with cesarean delivery (40.5% v. 23.3%, p < 0.001), low birth weight (26.9% v. 7.6%, p < 0.001), congenital malformation (0.5% v. 0.3%, p = 0.002) and admission to the neonatal intensive care unit (25.3% v. 9.7%, p < 0.001) was higher in the AHR group than the non-AHR group.
Interpretation: The incidence of live births following AHR pregnancies in Alberta was 5.1% between 2009 and 2018, and increased by 0.26% per year; newborns in the AHR group appeared smaller and showed signs of poorer health. This study provides insights on potential perinatal complications following AHR that may be important when caring for the newborn child.
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