Objective

To investigate hospitalizations up to 8 years after live birth among women who used assisted reproductive technology (ART) or who were subfertile compared with women who conceived naturally.

Design

Retrospective cohort.

Setting

Deliveries among privately insured women aged ≥18 years between 2004 and 2017 from Massachusetts state vital records were linked to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System and hospital observational/inpatient stays.

Patient(s)

We compared patients with ART, medically assisted reproduction (MAR), and unassisted subfertile (USF) delivery with those with fertile delivery.

Intervention(s)

NA.

Main Outcome Measure(s)

Postdelivery hospitalization information was derived from the International Classification of Diseases codes for discharges and combined by type. The relative risks and 95% confidence intervals (CIs) of hospitalization for up to the first 8 years postdelivery were modeled.

Result(s)

Among 492,515 deliveries, 5.6% used ART, 1.6% used MAR, and 1.8% were USF. Compared with fertile deliveries, deliveries that used ART or MAR or were USF were more likely to have hospital utilization (inpatient or observational stay) for any reason for up to 8 years of follow-up (USF, adjusted relative risk [aRR], 1.18 [95% CI, 1.12–1.25]; MAR, aRR, 1.20 [1.13–1.27]; and ART, aRR, 1.29 [1.25–1.34]). Assisted reproductive technology deliveries had an increased risk of hospitalization for conditions of the cardiovascular system (aRR, 1.31 [95% CI, 1.20–1.41]), overweight/obesity (aRR, 1.30 [1.17–1.44]), diabetes (aRR, 1.25 [1.05–1.49]), reproductive tract (aRR, 1.62 [1.47–1.79]), digestive tract (aRR, 1.39 [1.30–1.49]), thyroid (aRR, 2.02 [1.80–2.26]), respiratory system (aRR, 1.13 [1.03–1.24]), and cancer (aRR, 1.40 [1.18–1.65]) up to 8 years after delivery. Deliveries with MAR and subfertility had similar patterns of hospitalization as ART deliveries.

Conclusion(s)

Women who conceived through fertility treatment or experienced subfertility were at increased risk of subsequent hospitalization resulting from a variety of chronic and acute conditions.

中文翻译：

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接受辅助生殖技术治疗且生育能力低下的妇女在分娩后长达 8 年的住院治疗

客观的

调查使用辅助生殖技术 (ART) 或不育妇女与自然受孕妇女相比活产后长达 8 年的住院情况。

设计

回顾性队列。

环境

2004 年至 2017 年间，马萨诸塞州人口动态记录中年龄≥18 岁的私人保险妇女的分娩与辅助生殖技术协会临床结果报告系统和医院观察/住院时间相关联。

患者）

我们将接受 ART、医学辅助生殖 (MAR) 和无辅助不孕 (USF) 分娩的患者与可生育分娩的患者进行了比较。

干预措施

不适用。

主要观察指标）

分娩后住院信息来自国际疾病分类代码，用于出院并按类型组合。对产后前 8 年住院的相对风险和 95% 置信区间 (CI) 进行了建模。

结果）

在 492,515 次交付中，5.6% 使用 ART，1.6% 使用 MAR，1.8% 使用 USF。与可育分娩相比，使用 ART 或 MAR 或 USF 的分娩更有可能因任何原因进行住院（住院或观察）长达 8 年的随访（USF，调整后的相对风险 [aRR]，1.18 [95% CI，1.12–1.25]；MAR，aRR，1.20 [1.13–1.27]；ART，aRR，1.29 [1.25–1.34]）。辅助生殖技术分娩增加了因心血管系统疾病 (aRR, 1.31 [95% CI, 1.20–1.41])、超重/肥胖 (aRR, 1.30 [1.17–1.44])、糖尿病 (aRR, 1.25) 住院的风险[1.05–1.49])、生殖道 (aRR, 1.62 [1.47–1.79])、消化道 (aRR, 1.39 [1.30–1.49])、甲状腺 (aRR, 2.02 [1.80–2.26])、呼吸系统 (aRR, 1.13 [1.03–1.24]）和癌症（aRR，1.40 [1.18–1. 65]) 交付后最多 8 年。伴有 MAR 和生育力低下的分娩与 ART 分娩有相似的住院模式。

结论

通过生育治疗怀孕或经历过生育能力低下的妇女因各种慢性和急性病症而随后住院的风险增加。