Subfertility and Assisted Conception Study of Parent and Child Health Outcomes

生育力低下和亲子健康结果辅助受孕研究

• 批准号: 9920765
• 负责人: Hafsatou Diop
• 金额: $ 91.73万
• 依托单位: DARTMOUTH-HITCHCOCK CLINIC
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-17 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9920765
• 关键词: 1 year old; 4 year old; Acute; Admission activity; Affect; Age; Ambulatory Care; Anxiety; Applications Grants; Area; Assisted Reproductive Technology; Asthma; Birth; Birth Certificates; Blood Transfusion; Child; Child Health; Childhood; Chronic lung disease; Clinic; Companions; Conceptions; Congenital Abnormality; Control Groups; Data; Data Sources; Databases; Development; Diabetes Mellitus; Diagnosis; Diagnostic; Disease; Early Intervention; Emergency department visit; Event; Family; Fathers; Fertility; Fetal Death; Foundations; Gestational Diabetes; Grant; Health; Health Care Costs; Heart Diseases; Hospital Costs; Hospitals; Hypertension; Immune System Diseases; Infant Health; Infertility; Inflammatory; Information Systems; Insurance; Insurance Coverage; Life; Link; Low Birth Weight Infant; Massachusetts; Maternal Age; Measures; Medical; Mental Depression; Modality; Morbidity - disease rate; Mothers; Neonatal; Outcome; Outcome Measure; Outpatients; Parents; Pediatric Intensive Care Units; Pharmaceutical Preparations; Population; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Premature Birth; Procedures; Recording of previous events; Records; Reporting; Sample Size; Series; Small for Gestational Age Infant; Societies; Specialist; Study Subject; Surgical complication; System; Time; Tube; United States; Uterus; Visit; Woman; Women' s Group; Women' s Health; base; child bearing; cohort; comparison group; cost; cost estimate; data registry; diminished ovarian reserve; early childhood; endometriosis; feeding; health of the mother; high risk; hospital readmission; idiopathic infertility; infancy; infertility treatment; innovation; intervention program; longitudinal database; male; men; neonatal period; neoplasm registry; outpatient programs; perinatal health; population based; pregnancy hypertension; public health relevance; repository; reproductive; study population; subfertility

 DESCRIPTION (provided by applicant): Subfertility, defined as delayed time-to-conception, affects an estimated 12% of women of reproductive age. The use of fertility-enhancing therapies, including assisted reproductive technologies (ART), has risen steadily in the United States due to several factors, including childbearing at older maternal ages and increasing insurance coverage. Prior studies of women's and children's health after ART have been limited by small sample sizes, non-US populations, or ART treatments performed more than a decade ago, and the lack of appropriate control groups. An important understudied area is that of non-ART fertility treatments and the perinatal, infant, and child health outcomes of these pregnancies. Our original pair of grants was the first population-based analysis of women's and children's health after ART to be conducted in the US. These studies, which had the unique strength of including a non-ART-treated subfertility comparison group, yielded a series of analyses suggesting that underlying subfertility, rather than the treatment modality, is the foundation for most maternal and child morbidity. In this renewal, we will expand this understanding through increased information on subfertility-related diagnoses, underlying non-subfertility medical conditions, non-ART treatment parameters, and outcome measures present in the All Payers Claims Database, as well as inclusion of new information on fathers. We will evaluate the health of mothers during pregnancy and for five years post-delivery, and their children through age four. The study population will include all Massachusetts women who delivered pregnancies between 2004 and 2011 (our original birth cohort) and their children, and will add study subjects who delivered between 2012 and 2017. The total study population will include more than one million families. Reference groups will include ART and non-ART pregnancies with only male factor infertility, and pregnancies without indicators or treatment of subfertility. The study aims and hypotheses are: Aim 1: To evaluate the effect of maternal subfertility diagnoses on long-term health; Hypothesis: Women with a history of subfertility diagnoses, independent of treatment, have higher risks of compromised health outcomes compared to women without indicators or treatment of subfertility; Aim 2: To evaluate the health of children born to women and men with subfertility diagnoses; Hypothesis: Children born to women and/or men with subfertility diagnoses, independent of treatment, have a higher risk of compromised health outcomes compared to children born to women without indicators of subfertility; and Aim 3: To develop a cost-of-subfertility measure for women and their children; Hypothesis: Women with a history of subfertility-related diagnoses and their children have higher healthcare costs compared to their counterparts without indicators or treatment of subfertility.

 描述（由适用提供）：定义为延迟的时间概念的亚多属性影响了估计的生殖年龄妇女的12％。由于多种因素，包括辅助生殖技术（ART）在内的增强疗法（包括辅助生殖技术（ART））在美国稳步上升了，包括旧物料年龄的生育和增加的保险范围。先前对艺术后妇女和儿童健康的研究受到了十多年前进行的小样本量，非美国人群或艺术治疗的限制，并且缺乏适当的对照组。一个重要的理解领域是这些妊娠的非艺术生育治疗以及围产期，婴儿和儿童健康成果。我们最初的赠款是在美国进行艺术后对妇女和儿童健康的首次基于人群的分析。这些研究具有包括未经ART治疗的亚物质比较组的独特强度，得出了一系列分析，表明潜在的亚生物而不是治疗方式，是大多数母亲和儿童发病率的基础。在此续约中，我们将通过增加与亚物质相关诊断的信息扩大这种理解，这是所有付款人索赔数据库中存在的非屈服性医疗条件，非ART治疗参数和结果指标以及对父亲的新信息的包含。我们将在怀孕期间和交付后五年评估母亲的健康，并在四岁之前评估他们的孩子。研究人群将包括2004年至2011年（我们的原始出生队列）之间怀孕的所有马萨诸塞州妇女，并将增加在2012年至2017年之间交付的研究学科。总研究人群将包括超过一百万个家庭。参考组将包括仅具有男性因子不育症的艺术和非艺术妊娠，以及没有指标或治疗副不动性的妊娠。这项研究的目的和假设是：目标1：评估母体亚生物诊断对长期健康的影响；假设：与没有指标或治疗副不动性治疗的妇女相比，与治疗无关的诊断史（独立于治疗）的妇女具有更高的健康结果风险；目标2：评估具有诊断性差的男女所生的儿童的健康；假设：与没有属于副不动的儿童相比，妇女和/或具有不属性诊断的男性与治疗无关的男性患健康结果的风险更高；目标3：为妇女及其子女制定一种补充性措施；假设：与没有指标或治疗副不动性的妇女相比，与育种相关诊断史及其子女的医疗保健成本更高。

项目成果

Contributions to prematurity of maternal health conditions, subfertility, and assisted reproductive technology.

• DOI: 10.1016/j.fertnstert.2020.03.036
• 发表时间: 2020-10
• 期刊: Fertility and sterility
• 影响因子: 6.7
• 作者: Stern JE;Liu CL;Hwang SS;Dukhovny D;Diop H;Cabral H
• 通讯作者: Cabral H

The impact of single-step and sequential embryo culture systems on obstetric and perinatal outcomes in singleton pregnancies: the Massachusetts Outcomes Study of Assisted Reproductive Technology.

• DOI: 10.1016/j.fertnstert.2022.03.005
• 发表时间: 2022-06
• 期刊: FERTILITY AND STERILITY
• 影响因子: 6.7
• 作者: Sacha, Caitlin R.;Gopal, Daksha;Liu, Chia-Ling;Cabral, Howard R.;Stern, Judy E.;Carusi, Daniela A.;Racowsky, Catherine;Bormann, Charles L.
• 通讯作者: Bormann, Charles L.

Factors associated with increased odds of cesarean delivery in ART pregnancies.

• DOI: 10.1016/j.fertnstert.2018.04.032
• 发表时间: 2018-08
• 期刊: Fertility and sterility
• 影响因子: 6.7
• 作者: Stern JE;Liu CL;Cabral HJ;Richards EG;Coddington CC;Missmer SA;Diop H
• 通讯作者: Diop H

Association of maternal fertility status and receipt of fertility treatment with healthcare utilization in infants up to age four.

• DOI: 10.1038/s41372-021-01003-y
• 发表时间: 2021-10
• 期刊: Journal of perinatology : official journal of the California Perinatal Association
• 作者: Dukhovny D;Hwang SS;Gopal D;Cabral HJ;Diop H;Stern JE
• 通讯作者: Stern JE

Assisted reproductive technology treatment increases obstetric and neonatal risks over that of the underlying infertility diagnosis.

• DOI: 10.1016/j.fertnstert.2022.02.009
• 发表时间: 2022-06
• 期刊: FERTILITY AND STERILITY
• 影响因子: 6.7
• 作者: Stern, Judy E.;Liu, Chia-Ling;Cui, Xiaohui;Cabral, Howard J.;Farland, Leslie, V;Coddington, Charles;Diop, Hafsatou
• 通讯作者: Diop, Hafsatou