在第一次自然和医疗辅助生殖介导的活产后,第二次活产的概率:一项历史上的队列研究
Giovanna Esposito1, Fabio Parazzini1, Paola Viganò2
1Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Acta obstetricia et gynecologica Scandinavica
|October 9, 2023
概括
妇女使用医疗辅助生殖 (MAR) 为他们的第一个孩子有更低的可能性有第二个孩子. 在最初的MAR后,随后的MAR使用也较少.
科学领域:
- 生殖医学 生殖医学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 关于医疗辅助生殖 (MAR) 和实现理想的家庭规模的证据有限.
- 根据第一个出生的怀孕方法,调查第二次活产的怀孕概率和模式至关重要.
研究的目的:
- 评估第一次活产后第二次活产的概率,比较自然受孕与医疗辅助生殖 (MAR).
- 分析第二次分娩的受孕方式与第一次分娩的受孕方法相关.
主要方法:
- 一项历史的队列研究利用了意大利伦巴第省 (2007-2017) 的行政医疗数据.
- 卡普兰-梅尔法估计到2021年第二次活产的概率.
- 考克斯的比例危险模型分析了第一个出生的受孕模式和随后的活产概率之间的关联.
主要成果:
- 431,333名妇女通过自然受孕进行了第一次活产; 16,837人通过MAR.
- 第二次活产的概率在自然受孕后为58.6%,在MAR (HR=0.68) 后为32.1%.
- 在第一次MAR分娩的女性中,11.5%的人再次使用MAR,而第一次自然分娩的女性则为1.1%.
结论:
- 大约有十分之一的妇女在第一次MAR-介导分娩后再次使用MAR.
- 在第一次自然分娩的妇女中,随后的MAR使用明显较低.
- 在MAR需要进一步关注,以支持夫妇实现他们想要的孩子数量.
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