Advanced Reproductive Technology and Infant Health

先进的生殖技术和婴儿健康

• 批准号: 6856494
• 负责人: Marianne P Bitler
• 金额: $ 9.2万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-03-01 至 2008-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6856494
• 关键词: age at pregnancy; assistive reproductive technique; clinical research; epidemiology; family planning; fertility; gestational age; health; health care service availability; health care service utilization; health economics; health related legal; human birth weight; human data; human population study; human therapy evaluation; infant human (0-1 year); infant mortality; outcomes research; parity; twin /multiplet

DESCRIPTION (provided by applicant): Advanced reproductive technologies (ART) such as in vitro fertilization have radically improved since the late 1960s and have become increasingly common. The implicit assumption behind widespread use of ART has been that children born through ART use are similar to other children. Using variation provided by state mandates to insurers to cover infertility treatment, this research will test this assumption by estimating the demographic and health effects of ART use. This proposal's specific aims are to: (1) seek direct evidence about how common ART use is, the characteristics of women using ART, and how utilization is related to state laws mandating that insurers cover infertility treatment, using data from the National Survey of Family Growth (NSFG); (2) investigate the impacts of ART use and of state-mandated insurance coverage of infertility treatment on the number of births, maternal age at birth, and the incidence of multiple births, using both the NSFG and Vital Statistics birth certificate data; and (3) analyze the impacts of state-mandated insurance coverage of infertility treatment on birth weight, gestation, and infant mortality using Vital Statistics birth certificate data. This final specific aim is the core of this proposal and has important implications for the ongoing debate about birth selection in demography and health economics. ART and its demographic and health impacts are of interest. Further, ART generates an archetypal birth-selection problem, altering the infant health distribution not by affecting the health of a fixed infant population but by making it possible for a new subset of children to be born. Such birth selection raises important methodological and conceptual issues, which this work will address. This research faces a further methodological challenge: births through use of ART are a tiny share of all births, so sample sizes are likely to be quite small. However, preliminary studies have shown ART impacts can be clearly seen among twin births, especially among twins born to older mothers. This research will extend these preliminary studies to look at all births, and to look at additional outcomes such as infant mortality.

描述（由申请人提供）：自 20 世纪 60 年代末以来，体外受精等先进生殖技术 (ART) 得到了根本性的改进，并且变得越来越普遍。广泛使用辅助生殖技术背后的隐含假设是，通过辅助生殖技术出生的儿童与其他儿童相似。这项研究将利用州政府向保险公司提供的不孕不育治疗保险的变化，通过估计 ART 使用对人口和健康的影响来检验这一假设。该提案的具体目标是：(1) 使用全国家庭调查的数据，寻求直接证据，说明 ART 使用的普遍性、使用 ART 的女性的特征，以及使用与要求保险公司承保不孕不育治疗的州法律之间的关系。增长（NSFG）； (2) 利用 NSFG 和人口动态统计出生证明数据，调查 ART 的使用和国家规定的不孕不育治疗保险范围对出生人数、母亲出生年龄和多胞胎发生率的影响； (3) 利用生命统计出生证明数据分析国家规定的不孕不育治疗保险对出生体重、妊娠和婴儿死亡率的影响。最终的具体目标是该提案的核心，对于人口学和卫生经济学中正在进行的关于出生选择的辩论具有重要意义。 ART 及其对人口和健康的影响令人感兴趣。此外，ART 还产生了一个典型的出生选择问题，它改变了婴儿健康分布，不是通过影响固定婴儿群体的健康，而是通过使新的儿童子集出生成为可能。这种出生选择提出了重要的方法论和概念问题，本工作将解决这些问题。这项研究面临着进一步的方法论挑战：通过使用辅助生殖技术出生的婴儿只占所有出生婴儿的一小部分，因此样本量可能相当小。然而，初步研究表明，ART 的影响在双胞胎中可以明显看出，尤其是高龄母亲所生的双胞胎。这项研究将把这些初步研究扩展到所有出生情况，并研究婴儿死亡率等其他结果。