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Dispensing of clomiphene citrate to treat infertility: medication supplied and population prevalence of assisted pregnancies and multiple births
Fertility and Sterility ( IF 6.7 ) Pub Date : 2021-10-13 , DOI: 10.1016/j.fertnstert.2021.08.030
Vivienne Moore 1 , Alice Rumbold 2 , Renae Fernandez 3 , Heather McElroy 4 , Lynette Moore 5 , Lynne Giles 1 , Luke Grzeskowiak 6 , Elizabeth Roughead 7 , Michael Stark 3 , Michael Davies 3
Affiliation  

Objective

To determine the proportion of pregnancies resulting in birth that were conceived with the use of clomiphene citrate (CC) and the frequency of multiple pregnancy.

Design

Whole-of-population cohort study, constructed through data linkage. Comprehensive Australian Government records of dispensed medications were linked to state Perinatal Registry records for all births of at least 20 weeks’ gestation.

Setting

The state of South Australia.

Patient(s)

Women who maintained pregnancy for at least 20 weeks and gave birth between July 2003 and December 2015, a total of 150,713 women with 241,561 pregnancies.

Intervention(s)

Not applicable.

Main Outcome Measure(s)

Ongoing pregnancy occurring in proximity to CC, defined as dispensing from 90 days before to the end of a conception window derived from newborn date of birth and gestational age.

Result(s)

Linkage to dispensed prescription records was achieved for 97.9% of women. Women who conceived with CC tended to be older and socioeconomically advantaged and more likely than other women to have a history of miscarriage. Ongoing pregnancies associated with CC comprised 1.6% of the total; 5.7% were multiple births (mostly twins, 94.6%) compared with 1.5% in the remainder (98.5% twins).

Conclusion(s)

In South Australia, 1.6% of pregnancies (1 in 60) of at least 20 weeks’ gestation were conceived proximal to CC dispensing. Of these, 5.7% were multiple pregnancies. This takes the proportion of women who achieved an ongoing pregnancy with medical assistance from 4.4%, based on reports from assisted reproductive technology clinics, to 6% in total.



中文翻译:

分配克罗米芬治疗不孕症:药物供应和辅助妊娠和多胞胎的人口患病率

客观的

确定使用克罗米芬 (CC) 怀孕导致分娩的妊娠比例和多胎妊娠的频率。

设计

通过数据链接构建的全人群队列研究。澳大利亚政府发放药物的综合记录与所有至少怀孕 20 周的新生儿的州围产期登记记录相关联。

环境

南澳大利亚州。

耐心)

在 2003 年 7 月至 2015 年 12 月期间维持妊娠至少 20 周并分娩的女性,共有 150,713 名女性,241,561 次怀孕。

干预措施

不适用。

主要观察指标)

在 CC 附近发生的持续妊娠,定义为从新生儿出生日期和胎龄得出的受孕窗口结束前 90 天分配。

结果)

97.9% 的女性实现了与配药处方记录的关联。与 CC 一起怀孕的女性往往年龄更大、社会经济地位更高,并且比其他女性更有可能有流产史。与 CC 相关的持续妊娠占总数的 1.6%;5.7% 为多胞胎(主要是双胞胎,94.6%),其余为 1.5%(98.5% 双胞胎)。

结论

在南澳大利亚,至少 20 周妊娠的孕妇中有 1.6%(60 人中有 1 人)是在 CC 分配附近受孕的。其中,5.7% 为多胎妊娠。根据辅助生殖技术诊所的报告,这使得在医疗援助下持续怀孕的女性比例从 4.4% 增加到 6%。

更新日期:2021-10-13
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