国家复数出生率增长的阳性和人口决定因素
Eli Y Adashi1, Alan S Penzias2, Philip A Gruppuso1
1Department of Medical Science, Warren Alpert Medical School, Brown University, Providence, Rhode Island.
Fertility and sterility
|January 21, 2024
概括
排卵诱导和卵巢刺激是美国多胎儿增加的主要原因. 减少这些干预措施可以帮助减轻相关的孕产妇和婴儿健康风险.
科学领域:
- 生殖医学和公共卫生监测.
- 分析国家出生趋势和促成因素.
背景情况:
- 多重分娩,包括双胞胎和更高阶的多重分娩,与不利的母亲和婴儿健康结果有关.
- 美国多胎儿的增加与辅助生殖技术和其他干预措施有关.
研究的目的:
- 量化排卵诱导,卵巢刺激,体外受精 (IVF) 和无助受孕对美国多胎出生增加的贡献.
- 确定多胎出生的主要驱动因素,以告知公共卫生干预措施.
主要方法:
- 利用来自国家生命统计系统 (1967-2021) 和国家辅助生殖技术监测系统 (1997-2021) 的国家出生数据.
- 采用贝叶斯逻辑模型来估计不同母亲年龄组的无助受孕贡献 (1949-1966).
- 通过减去IVF辅助和无辅助怀孕从多重分娩总数中计算了排卵诱导和卵巢刺激的贡献.
主要成果:
- 全国双胞胎出生率在2014年达到顶峰,而三胞胎和更高阶出生率在1998年达到顶峰,随后下降.
- 2021年,35岁以下妇女的无助受孕占多重分娩的最大份额 (56.1%),其次是排卵诱导/卵巢刺激 (19.5%),35岁以上妇女的无助受孕 (16.8%) 和试管婴儿 (7.6%).
- 在2009-2021年期间,排卵诱导/卵巢刺激的贡献保持稳定,无助受孕的贡献增加,而试管婴儿的贡献减少.
结论:
- 排卵诱导和卵巢刺激被确定为美国多重分娩的主要阳性原因.
- 这些干预措施代表了旨在减少与多胎分娩相关的健康风险的战略的关键目标.
- 增加母亲年龄 (≥35岁) 也是导致全国多胎出生率上升的一个重要因素.
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