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Stewart SL, Crawford A, Shev AB, Wintemute G, Tseregounis IE, Henry SG. Comparison of record linkage software for deduplicating patient identities in California's Prescription Drug Monitoring Program. Pharmacoepidemiol Drug Saf 2024; 33:e5699. [PMID: 37779337 DOI: 10.1002/pds.5699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/24/2023] [Accepted: 09/11/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND To help prevent overdose deaths involving prescription drugs, accurate linkage of prescription drug monitoring program (PDMP) records for individual patients is essential. OBJECTIVES To compare the accuracy of the linkage program used by California's PDMP against various record linkage programs with respect to accuracy in deduplicating patient identities in the PDMP, with implications for identifying high-risk opioid use and outlier behaviors. RESEARCH DESIGN We evaluated California's program, Link Plus, LinkSolv, and The Link King on 557 861 PDMP identity records with addresses in two 3-digit zip code areas for patients who filled a controlled substance prescription in 2013. Manual review was performed on a stratified sample of 720 paired records identified as matches by at least one program. MEASURES We estimated sensitivity and positive predictive value, and computed PDMP patient alerts for the patient entities identified by each program. RESULTS Sensitivity was 95% for LinkSolv and The Link King, 84% for Link Plus, and 73% for California's program; positive predictive value was ≥93% for all programs. The number of patient entities prompting a PDMP alert was similar among the programs for all alerts except multiple provider episodes (obtaining prescriptions from ≥6 prescribers or ≥6 pharmacies in the last 6 months), which were 10.9%, 26.6%, and 16.9% greater using The Link King, Link Plus, and LinkSolv, respectively, compared to California's program. CONCLUSIONS PDMPs should assess the accuracy of record linkage algorithms and the impacts of these algorithms on patient safety alerts and develop national best practices for PDMP record linkage.
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Affiliation(s)
- Susan L Stewart
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Andrew Crawford
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Sacramento, California, USA
| | - Aaron B Shev
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Sacramento, California, USA
| | - Garen Wintemute
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, Sacramento, California, USA
| | - Iraklis Erik Tseregounis
- Division of General Internal Medicine, University of California, Davis, Sacramento, California, USA
| | - Stephen G Henry
- Division of General Internal Medicine, University of California, Davis, Sacramento, California, USA
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Chang J, Zhang Y, Boulet SL, Crawford SB, Copeland GE, Bernson D, Kirby RS, Kissin DM, Barfield WD. Assisted Reproductive Technology and Perinatal Mortality: Selected States (2006-2011). Am J Perinatol 2023; 40:953-959. [PMID: 34282572 PMCID: PMC11057010 DOI: 10.1055/s-0041-1732451] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to compare trends and characteristics of assisted reproductive technology (ART) and non-ART perinatal deaths and to evaluate the association of perinatal mortality and method of conception (ART vs. non-ART) among ART and non-ART deliveries in Florida, Massachusetts, and Michigan from 2006 to 2011. STUDY DESIGN Retrospective cohort study using linked ART surveillance and vital records data from Florida, Massachusetts, and Michigan. RESULTS During 2006 to 2011, a total of 570 ART-conceived perinatal deaths and 25,158 non-ART conceived perinatal deaths were identified from the participating states. Overall, ART perinatal mortality rates were lower than non-ART perinatal mortality rates for both singletons (7.0/1,000 births vs. 10.2/1,000 births) and multiples (22.8/1,000 births vs. 41.2/1,000 births). At <28 weeks of gestation, the risk of perinatal death among ART singletons was significantly lower than non-ART singletons (adjusted risk ratio [aRR] = 0.46, 95% confidence interval [CI]: 0.26-0.85). Similar results were observed among multiples at <28 weeks of gestation (aRR = 0.64, 95% CI: 0.45-0.89). CONCLUSION Our findings suggest that ART use is associated with a decreased risk of perinatal deaths prior to 28 weeks of gestation, which may be explained by earlier detection and management of fetal and maternal conditions among ART-conceived pregnancies. These findings provide valuable information for health care providers, including infertility specialists, obstetricians, and pediatricians when counseling ART users on risk of treatment. KEY POINTS · ART use is associated with a decreased risk of perinatal deaths prior to 28 weeks of gestation.. · ART perinatal mortality rates were lower than that for non-ART perinatal mortality.. · This study used linked data to examine associations between use of ART and perinatal deaths..
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Affiliation(s)
- Jeani Chang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yujia Zhang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sheree L. Boulet
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Sara B. Crawford
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Dana Bernson
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Russell S. Kirby
- College of Public Health, University of South Florida, Tampa, Florida
| | - Dmitry M. Kissin
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wanda D. Barfield
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Chambers GM, Choi SKY, Irvine K, Venetis C, Harris K, Havard A, Norman RJ, Lui K, Ledger W, Jorm LR. A bespoke data linkage of an IVF clinical quality registry to population health datasets; methods and performance. Int J Popul Data Sci 2021; 6:1679. [PMID: 34549093 PMCID: PMC8436881 DOI: 10.23889/ijpds.v6i1.1679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction Assisted reproductive technologies (ART), such as in-vitro fertilisation (IVF), have revolutionised the treatment of infertility, with an estimated 8 million babies born worldwide. However, the long-term health outcomes for women and their offspring remain an area of concern. Linking IVF treatment data to long-term health data is the most efficient method for assessing such outcomes. Objectives To describe the creation and performance of a bespoke population-based data linkage of an ART clinical quality registry to state-based and national administrative datasets. Methods The linked dataset was created by deterministically and probabilistically linking the Australia and New Zealand Assisted Reproduction Database (ANZARD) to New South Wales (NSW) and Australian Capital Territory (ACT) administrative datasets (performed by NSW Centre for Health Record Linkage (CHeReL)) and to national claims datasets (performed by Australian Institute of Health and Welfare (AIHW)). The CHeReL’s Master Linkage Key (MLK) was used as a bridge between ANZARD’s partially identifiable patient data (statistical linkage key) and NSW and ACT administrative datasets. CHeReL then provided personal identifiers to the AIHW to obtain national content data. The results of the linkage were reported, and concordance between births recorded in ANZARD and perinatal data collections (PDCs) was evaluated. Results Of the 62,833 women who had ART treatment in NSW or ACT, 60,419 could be linked to the CHeReL MLK (linkage rate: 96.2%). A reconciliation of ANZARD-recorded births among NSW residents found that 94.2% (95% CI: 93.9–94.4%) of births were also recorded in state/territory-based PDCs. A high concordance was found in plurality status and birth outcome ≥99% agreement rate, Cohen’s kappa ranged: 0.78–0.98) between ANZARD and PDCs. Conclusion The data linkage resource demonstrates that high linkage rates can be achieved with partially identifiable data and that a population spine, such as the CHeReL’s MLK, can be successfully used as a bridge between clinical registries and administrative datasets.
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Affiliation(s)
- Georgina M Chambers
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Stephanie K Y Choi
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Katie Irvine
- Centre for Health Record Linkage, Ministry of Health, New South Wales, Australia
| | - Christos Venetis
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Katie Harris
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Alys Havard
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Robert J Norman
- The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kei Lui
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - William Ledger
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Louisa R Jorm
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Sites CK, Wilson D, Bernson D, Boulet S, Zhang Y. Number of embryos transferred and diagnosis of preeclampsia. Reprod Biol Endocrinol 2020; 18:68. [PMID: 32653045 PMCID: PMC7353780 DOI: 10.1186/s12958-020-00627-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/30/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Multiple births and first pregnancy are associated with higher preeclampsia risk. It is unknown if the transfer of multiple embryos or first embryo transfer with assisted reproductive technology (ART) is also associated with greater preeclampsia risk. METHODS We performed a retrospective cohort study of IVF clinics and hospitals in Massachusetts. We used linked ART surveillance, birth certificate, and maternal hospitalization discharge data for 21,188 births, considering resident singleton (12,810) and twin (8378) live-births from autologous or donor eggs from 2005 to 2012. We used log binomial and Poisson regression to calculate adjusted relative risks (aRRs) and 95% confidence intervals (CI) for the association between preeclampsia and predictors of preeclampsia. Outcomes were stratified by singleton and twin birth, donor versus autologous cycles, and use of fresh versus cryopreserved embryos. RESULTS Considering all singleton births, the transfer of multiple embryos increased the risk of preeclampsia [aRR = 1.10 (95% CI: 1.01-1.19)]. Relative risks were greatest for fresh non-donor cycles [aRR = 1.14 (95% CI: 1.03-1.26)]. Vanishing twin and number of prior ART cycles was not associated with preeclampsia among singleton births [aRR = 1.18 (95% CI: 0.91-1.53)], and aRR = 1.01 (95% CI: 0.96-1.05)], respectively. Considering all twin births, the transfer of > 2 embryos increased the risk of preeclampsia [aRR = 1.09 (95% CI: 1.001-1.19)]. Vanishing triplet and number of prior ART cycles were not associated with preeclampsia among twin births [aRR = 0.93 (95% CI: 0.69-1264), and aRR = 0.98 (CI: 0.95-1.02)], respectively. CONCLUSIONS Among ART births, the transfer of more than 1 embryo for singleton gestations and more than 2 embryos for twin gestations increased the risk for preeclampsia diagnosis.
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Affiliation(s)
- Cynthia K Sites
- Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Baystate, 759 Chestnut Street, S1683, Springfield, MA, 01199, USA.
| | - Donna Wilson
- Department of Epidemiology and Biostatistics, Baystate Medical Center, Springfield, MA, USA
| | | | - Sheree Boulet
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Yujia Zhang
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Bacal V, Russo M, Fell DB, Shapiro H, Walker M, Gaudet LM. A systematic review of database validation studies among fertility populations. Hum Reprod Open 2019; 2019:hoz010. [PMID: 31206038 PMCID: PMC6561328 DOI: 10.1093/hropen/hoz010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/20/2019] [Indexed: 12/12/2022] Open
Abstract
STUDY QUESTION Are routinely collected data from fertility populations adequately validated? SUMMARY ANSWER Of the 19 studies included, only one validated a national fertility registry and none reported their results in accordance with recommended reporting guidelines for validation studies. WHAT IS KNOWN ALREADY Routinely collected data, including administrative databases and registries, are excellent sources of data, particularly for reporting, quality assurance, and research. However, these data are subject to misclassification bias due to misdiagnosis or errors in data entry and therefore need to be validated prior to using for clinical or research purposes. STUDY DESIGN SIZE DURATION We conducted a systematic review by searching Medline, Embase, and CINAHL from inception to 6 October 2016 to identify validation studies of databases that contain routinely collected data in an ART setting. Webpages of international ART centers were also searched. PARTICIPANTS/MATERIALS SETTING METHODS We included studies that compared at least two data sources to validate ART population data. Key words and MeSH terms were adapted from previous systematic reviews investigating routinely collected data (e.g. administrative databases and registries), measures of validity (including sensitivity, specificity, and predictive value), and ART (including infertility, IVF, advanced reproductive age, and diminished ovarian reserve). Only full-text studies in English were considered. Results were synthesized qualitatively. The electronic search yielded 1074 citations, of which 19 met the inclusion criteria. MAIN RESULTS AND THE ROLE OF CHANCE Two studies validated a fertility database using medical records; seven studies used an IVF registry to validate vital records or maternal questionnaires, and two studies failed to adequately describe their reference standard. Four studies investigated the validity of mode of conception from birth registries; two studies validated diagnoses or treatments in a fertility database; four studies validated a linkage algorithm between a fertility registry and another administrative database; one study created an algorithm in a single database to identify a patient population. Sensitivity was the most commonly reported measure of validity (12 studies), followed by specificity (9 studies). Only three studies reported four or more measures of validation, and five studies presented CIs for their estimates. The prevalence of the variable in the target population (pre-test prevalence) was reported in seven studies; however, only four of the studies had prevalence estimates from the study population (post-test prevalence) within a 2% range of the pre-test estimate. The post-test estimate was largely discrepant from the pre-test value in two studies. LIMITATIONS REASONS FOR CAUTION The search strategy was limited to the studies and reports published in English, which may not capture validation studies from countries that do not speak English. Furthermore, only three specific fertility-based diagnostic variables (advanced reproductive age, diminished ovarian reserve, and chorionicity) were searched in Medline, Embase, and CINAHL. Consequently, published studies with other diagnoses or conditions relevant to infertility may not have been captured in our review. WIDER IMPLICATIONS OF THE FINDINGS There is a paucity of literature on validation of routinely collected data from a fertility population. Furthermore, the prevalence of the markers that have been validated are not being presented, which can lead to biased estimates. Stakeholders rely on these data for monitoring outcomes of treatments and adverse events; therefore, it is essential to ascertain the accuracy of these databases and make the reports publicly available. STUDY FUNDING/COMPETING INTERESTS This study was supported by Canadian Institutes of Health Research (CIHR) (FDN-148438). There are no competing interests for any of the authors. REGISTRATION NUMBER International Prospective Register of Systematic Reviews ID: CRD42016048466.
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Affiliation(s)
- V Bacal
- School of Epidemiology and Public Health (SEPH), University of Ottawa, Ottawa, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - M Russo
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada
- Mount Sinai Fertility, Toronto, Canada
| | - D B Fell
- School of Epidemiology and Public Health (SEPH), University of Ottawa, Ottawa, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
- Institute for Clinical Evaluative Sciences, Ottawa, Canada
| | - H Shapiro
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada
- Mount Sinai Fertility, Toronto, Canada
| | - M Walker
- School of Epidemiology and Public Health (SEPH), University of Ottawa, Ottawa, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - L M Gaudet
- School of Epidemiology and Public Health (SEPH), University of Ottawa, Ottawa, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
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Sites CK, Wilson D, Barsky M, Bernson D, Bernstein IM, Boulet S, Zhang Y. Embryo cryopreservation and preeclampsia risk. Fertil Steril 2017; 108:784-790. [PMID: 28974308 PMCID: PMC10999961 DOI: 10.1016/j.fertnstert.2017.08.035] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/09/2017] [Accepted: 08/25/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine whether assisted reproductive technology (ART) cycles involving cryopreserved-warmed embryos are associated with the development of preeclampsia. DESIGN Retrospective cohort study. SETTING IVF clinics and hospitals. PATIENT(S) A total of 15,937 births from ART: 9,417 singleton and 6,520 twin. INTERVENTION(S) We used linked ART surveillance, birth certificate, and maternal hospitalization discharge data, considering resident singleton and twin births from autologous or donor eggs from 2005-2010. MAIN OUTCOME MEASURE(S) We compared the frequency of preeclampsia diagnosis for cryopreserved-warmed versus fresh ET and used multivariable logistic regression to adjust for confounders. RESULT(S) Among pregnancies conceived with autologous eggs resulting in singletons, preeclampsia was greater after cryopreserved-warmed versus fresh ET (7.51% vs. 4.29%, adjusted odds ratio = 2.17 [95% CI 1.67-2.82]). Preeclampsia without and with severe features, preeclampsia with preterm delivery, and chronic hypertension with superimposed preeclampsia were more frequent after cryopreserved-warmed versus fresh ET (3.99% vs. 2.55%; 2.95% vs. 1.41%; 2.76 vs. 1.48%; and 0.95% vs. 0.43%, respectively). Among pregnancies from autologous eggs resulting in twins, the frequency of preeclampsia with severe features (9.26% vs. 5.70%) and preeclampsia with preterm delivery (14.81% vs. 11.74%) was higher after cryopreserved versus fresh transfers. Among donor egg pregnancies, rates of preeclampsia did not differ significantly between cryopreserved-warmed and fresh ET (10.78% vs. 12.13% for singletons and 28.0% vs. 25.15% for twins). CONCLUSION(S) Among ART pregnancies conceived using autologous eggs resulting in live births, those involving transfer of cryopreserved-warmed embryos, as compared with fresh ETs, had increased risk for preeclampsia with severe features and preeclampsia with preterm delivery.
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Affiliation(s)
- Cynthia K Sites
- Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, Massachusetts.
| | - Donna Wilson
- Department of Epidemiology and Biostatistics, Baystate Medical Center, Springfield, Massachusetts
| | - Maya Barsky
- Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, Massachusetts
| | - Dana Bernson
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Ira M Bernstein
- Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont
| | - Sheree Boulet
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yujia Zhang
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Dunietz GL, Holzman C, Zhang Y, Li C, Todem D, Boulet SL, McKane P, Kissin DM, Copeland G, Bernson D, Diamond MP. Assisted reproduction and risk of preterm birth in singletons by infertility diagnoses and treatment modalities: a population-based study. J Assist Reprod Genet 2017; 34:1529-1535. [PMID: 28755152 DOI: 10.1007/s10815-017-1003-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 07/21/2017] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The purpose of this study is to examine the spectrum of infertility diagnoses and assisted reproductive technology (ART) treatments in relation to risk of preterm birth (PTB) in singletons. METHODS Population-based assisted reproductive technology surveillance data for 2000-2010 were linked with birth certificates from three states: Florida, Massachusetts, and Michigan, resulting in a sample of 4,370,361 non-ART and 28,430 ART-related singletons. Logistic regression models with robust variance estimators were used to compare PTB risk among singletons conceived with and without ART, the former grouped by parental infertility diagnoses and treatment modalities. Demographic and pregnancy factors were included in adjusted analyses. RESULTS ART was associated with increased PTB risk across all infertility diagnosis groups and treatment types: for conventional ART, adjusted relative risks ranged from 1.4 (95% CI 1.0, 1.9) for male infertility to 2.4 (95% CI 1.8, 3.3) for tubal ligation. Adding intra-cytoplasmic sperm injection and/or assisted hatching to conventional ART treatment did not alter associated PTB risks. Singletons conceived by mothers without infertility diagnosis and with donor semen had an increased PTB risk relative to non-ART singletons. CONCLUSIONS PTB risk among ART singletons is increased within each treatment type and all underlying infertility diagnosis, including male infertility. Preterm birth in ART singletons may be attributed to parental infertility, ART treatments, or their combination.
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Affiliation(s)
- Galit Levi Dunietz
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
- Department of Neurology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5845, USA.
| | - Claudia Holzman
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Yujia Zhang
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Chenxi Li
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - David Todem
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Sheree L Boulet
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Patricia McKane
- Maternal and Child Health Epidemiology Section, Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Dmitry M Kissin
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Glenn Copeland
- Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Dana Bernson
- Massachusetts Department of Public Health, Boston, MA, USA
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Augusta University, Augusta, GA, USA
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Maternal Racial and Ethnic Disparities in Neonatal Birth Outcomes With and Without Assisted Reproduction. Obstet Gynecol 2017; 129:1022-1030. [PMID: 28486370 DOI: 10.1097/aog.0000000000002031] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To explore disparities in prematurity and low birth weight (LBW) by maternal race and ethnicity among singletons conceived with and without assisted reproductive technology (ART). METHODS We performed a retrospective cohort study using resident birth certificate data from Florida, Massachusetts, and Michigan linked with data from the National ART Surveillance System from 2000 to 2010. There were 4,568,822 live births, of which 64,834 were conceived with ART. We compared maternal and ART cycle characteristics of singleton liveborn neonates using χ tests across maternal race and ethnicity groups. We used log binomial models to explore associations between maternal race and ethnicity and LBW and preterm birth by ART conception status. RESULTS The proportion of liveborn neonates conceived with ART differed by maternal race and ethnicity (P<.01). It was smallest among neonates of non-Hispanic black (0.3%) and Hispanic women (0.6%) as compared with neonates of non-Hispanic white (2.0%) and Asian or Pacific Islander women (1.9%). The percentages of LBW or preterm singletons were highest for neonates of non-Hispanic black women both for non-ART (11.3% and 12.4%) and ART (16.1% and 19.1%) -conceived neonates. After adjusting for maternal factors, the risks of LBW or preterm birth for singletons born to non-Hispanic black mothers were 2.12 [95% confidence interval (CI) 2.10-2.14] and 1.56 (95% CI 1.54-1.57) times higher for non-ART neonates and 1.87 (95% CI 1.57-2.23) and 1.56 (95% CI 1.34-1.83) times higher for ART neonates compared with neonates of non-Hispanic white women. The adjusted risk for LBW was also significantly higher for ART and non-ART singletons born to Hispanic (adjusted relative risk [RR] 1.26, 95% CI 1.09-1.47 and adjusted RR 1.15, 95% CI 1.13-1.16) and Asian or Pacific Islander (adjusted RR 1.39, 95% CI 1.16-1.65 and adjusted RR 1.55, 95% CI 1.52-1.58) women compared with non-Hispanic white women. CONCLUSION Disparities in adverse perinatal outcomes by maternal race and ethnicity persisted for neonates conceived with and without ART.
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Zhang Y, Crawford S, Boulet SL, Monsour M, Cohen B, McKane P, Freeman K. Using multiple imputation to address the inconsistent distribution of a controlling variable when modeling an infrequent outcome. JOURNAL OF MODERN APPLIED STATISTICAL METHODS 2017; 16:744-752. [PMID: 30393468 DOI: 10.22237/jmasm/1493599140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Temporal changes in methods for collecting longitudinal data can generate inconsistent distributions of affected variables, but effects on parameter estimates have not been well described. We examined differences in Apgar scores of infants born in 2000-2006 to women with ovulatory dysfunction (risk) or tubal obstruction (reference) who underwent assisted reproductive technology (ART), using Florida, Massachusetts, and Michigan birth certificate data linked to the Centers for Disease Control and Prevention's National ART Surveillance System database. Florida had inconsistent information on induction of labor (a control variable) from a 2004 change in birth certificate format. Because we wanted to control for bias that may be introduced by the inconsistent distribution of labor induction in analysis, we used multiple imputation data in analysis. We used Cox-Iannacchione weighted sequential hot deck method to conduct multiple imputation for the labor induction values in Florida data collected before this change, and missing values in Florida data collected after the change and overall Massachusetts and Michigan data. The adjusted odds ratios for low Apgar score were 1.94 (95% confidence interval [CI] 1.32-2.85) using imputed induction of labor and 1.83 (95% CI 1.20-2.80) using not imputed induction of labor. Compared with the estimate from multiple imputation, the estimate obtained using not imputed induction of labor was biased towards the null with inflated standard errors, but the magnitude of differences was small.
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Affiliation(s)
- Yujia Zhang
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sara Crawford
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sheree L Boulet
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael Monsour
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Bruce Cohen
- Massachusetts Department of Public Health, Boston
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10
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Dunietz GL, Holzman C, Zhang Y, Talge NM, Li C, Todem D, Boulet SL, McKane P, Kissin DM, Copeland G, Bernson D, Diamond MP. Assisted Reproductive Technology and Newborn Size in Singletons Resulting from Fresh and Cryopreserved Embryos Transfer. PLoS One 2017; 12:e0169869. [PMID: 28114395 PMCID: PMC5256964 DOI: 10.1371/journal.pone.0169869] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 12/22/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES AND STUDY DESIGN The aim of this study was two-fold: to investigate the association of Assisted Reproductive Technology (ART) and small newborn size, using standardized measures; and to examine within strata of fresh and cryopreserved embryos transfer, whether this association is influenced by parental infertility diagnoses. We used a population-based retrospective cohort from Michigan (2000-2009), Florida and Massachusetts (2000-2010). Our sample included 28,946 ART singletons conceived with non-donor oocytes and 4,263,846 non-ART singletons. METHODS Regression models were used to examine the association of ART and newborn size, measured as small for gestational age (SGA) and birth-weight-z-score, among four mutually exclusive infertility groups: female infertility only, male infertility only, combined female and male infertility, and unexplained infertility, stratified by fresh and cryopreserved embryos transfer. RESULTS We found increased SGA odds among ART singletons from fresh embryos transfer compared with non-ART singletons, with little difference by infertility source [adjusted odds-ratio for SGA among female infertility only: 1.18 (95% CI 1.10, 1.26), male infertility only: 1.20 (95% CI 1.10, 1.32), male and female infertility: 1.18 (95% CI 1.06, 1.31) and unexplained infertility: 1.24 (95% CI 1.10, 1.38)]. Conversely, ART singletons, born following cryopreserved embryos transfer, had lower SGA odds compared with non-ART singletons, with mild variation by infertility source [adjusted odds-ratio for SGA among female infertility only: 0.56 (95% CI 0.45, 0.71), male infertility only: 0.64 (95% CI 0.47, 0.86), male and female infertility: 0.52 (95% CI 0.36, 0.77) and unexplained infertility: 0.71 (95% CI 0.47, 1.06)]. Birth-weight-z-score was significantly lower for ART singletons born following fresh embryos transfer than non-ART singletons, regardless of infertility diagnoses.
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Affiliation(s)
- Galit Levi Dunietz
- Department of Neurology, University of Michigan, Ann Arbor, MI, United States of America.,Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United States of America
| | - Claudia Holzman
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United States of America
| | - Yujia Zhang
- Division of Reproductive Health at the Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Nicole M Talge
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United States of America
| | - Chenxi Li
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United States of America
| | - David Todem
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, United States of America
| | - Sheree L Boulet
- Division of Reproductive Health at the Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Patricia McKane
- Michigan Department of Health and Human Services, Maternal and Child Health Epidemiology Section, Lansing, MI, United States of America
| | - Dmitry M Kissin
- Division of Reproductive Health at the Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Glenn Copeland
- Michigan Department of Health and Human Services, Division for Vital Records and Health Statistics, Lansing, MI, United States of America
| | - Dana Bernson
- Massachusetts Department of Public Health, Boston, MA, United States of America
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Augusta University, Augusta, GA, United States of America
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Kesinger M, Kumar RG, Ritter AC, Sperry JL, Wagner AK. Probabilistic Matching Approach to Link Deidentified Data from a Trauma Registry and a Traumatic Brain Injury Model System Center. Am J Phys Med Rehabil 2017; 96:17-24. [PMID: 27088479 PMCID: PMC5065730 DOI: 10.1097/phm.0000000000000513] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE There is no civilian traumatic brain injury database that captures patients in all settings of the care continuum. The linkage of such databases would yield valuable insight into possible care interventions. Thus, the objective of this article is to describe the creation of an algorithm used to link the Traumatic Brain Injury Model System (TBIMS) to trauma data in state and national trauma databases. DESIGN The TBIMS data from a single center was randomly divided into two sets. One subset was used to generate a probabilistic linking algorithm to link the TBIMS data to the center's trauma registry. The other subset was used to validate the algorithm. Medical record numbers were obtained and used as unique identifiers to measure the quality of the linkage. Novel methods were used to maximize the positive predictive value. RESULTS The algorithm generation subset had 121 patients. It had a sensitivity of 88% and a positive predictive value of 99%. The validation subset consisted of 120 patients and had a sensitivity of 83% and a positive predictive value of 99%. CONCLUSIONS The probabilistic linkage algorithm can accurately link TBIMS data across systems of trauma care. Future studies can use this database to answer meaningful research questions regarding the long-term impact of the acute trauma complex on health care utilization and recovery across the care continuum in traumatic brain injury populations.
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Affiliation(s)
| | - RG. Kumar
- Department of Physical Medicine and Rehabilitation
- Department of Epidemiology
| | - AC. Ritter
- Department of Physical Medicine and Rehabilitation
- Department of Epidemiology
| | | | - AK. Wagner
- Department of Physical Medicine and Rehabilitation
- Department of Neuroscience
- Safar Center for Resuscitation Research
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12
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Boulet SL, Kirby RS, Reefhuis J, Zhang Y, Sunderam S, Cohen B, Bernson D, Copeland G, Bailey MA, Jamieson DJ, Kissin DM. Assisted Reproductive Technology and Birth Defects Among Liveborn Infants in Florida, Massachusetts, and Michigan, 2000-2010. JAMA Pediatr 2016; 170:e154934. [PMID: 27043648 PMCID: PMC4899282 DOI: 10.1001/jamapediatrics.2015.4934] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Use of assisted reproductive technology (ART) has been associated with increased risks for birth defects. Variations in birth defect risks according to type of ART procedure have been noted, but findings are inconsistent. OBJECTIVES To examine the prevalence of birth defects among liveborn infants conceived with and without ART and to evaluate risks associated with certain ART procedures among ART-conceived infants. DESIGN, SETTING, AND PARTICIPANTS Used linked ART surveillance, birth certificates, and birth defects registry data for 3 states (Florida, Massachusetts, and Michigan). Methods for ascertaining birth defect cases varied by state. Resident live births during 2000 to 2010 were included, and the analysis was conducted between Feburary 2015 and August 2015. EXPOSURES Use of ART among all live births and use of certain ART procedures among ART births. MAIN OUTCOME AND MEASURES Prevalence of selected chromosomal and nonchromosomal birth defects that are usually diagnosed at or immediately after birth. RESULTS Of the 4 618 076 liveborn infants between 2000 and 2010, 64 861 (1.4%) were conceived using ART. Overall, the prevalence of 1 or more of the selected nonchromosomal defects was 58.59 per 10 000 for ART infants (n = 389) vs 47.50 per 10 000 for non-ART infants (n = 22 036). The association remained significant after adjusting for maternal characteristics and year of birth (adjusted risk ratio [aRR], 1.28; 95% CI, 1.15-1.42). Similar differences were observed for singleton ART births vs their non-ART counterparts (63.69 per 10 000 [n = 218] vs 47.17 per 10 000 [n = 21 251]; aRR, 1.38; 95% CI, 1.21-1.59). Among multiple births, the prevalence of rectal and large intestinal atresia/stenosis was higher for ART births compared with non-ART births (aRR, 2.39; 95% CI, 1.38-4.12). Among ART births conceived after fresh embryo transfer, infants born to mothers with ovulation disorders had a higher prevalence of nonchromosomal birth defects (aRR, 1.53; 95% CI, 1.13-2.06) than those born to mothers without the diagnosis, and use of assisted hatching was associated with birth defects among singleton births (aRR, 1.55; 95% CI, 1.10-2.19). Multiplicity-adjusted P values for these associations were greater than .05. CONCLUSIONS AND RELEVANCE Infants conceived after ART had a higher prevalence of certain birth defects. Assisted hatching and diagnosis of ovulation disorder were marginally associated with increased risks for nonchromosomal birth defects; however, these associations may be caused by other underlying factors.
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Affiliation(s)
- Sheree L. Boulet
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Jennita Reefhuis
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yujia Zhang
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Saswati Sunderam
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bruce Cohen
- Massachusetts Department of Public Health, Boston
| | - Dana Bernson
- Massachusetts Department of Public Health, Boston
| | - Glenn Copeland
- Michigan Department of Health and Human Services, Lansing
| | | | - Denise J. Jamieson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dmitry M. Kissin
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Tong VT, Kissin DM, Bernson D, Copeland G, Boulet SL, Zhang Y, Jamieson DJ, England LJ. Maternal Smoking Among Women With and Without Use of Assisted Reproductive Technologies. J Womens Health (Larchmt) 2016; 25:1066-1072. [PMID: 27243366 DOI: 10.1089/jwh.2015.5662] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To estimate smoking prevalence during the year before pregnancy and during pregnancy and adverse outcomes among women who delivered infants with and without assisted reproductive technology (ART) using linked birth certificates (BC) and National ART Surveillance System (NASS) data. METHODS Data were analyzed for 384,390 women and 392,248 infants born in Massachusetts and Michigan during 2008-2009. Maternal smoking prevalence was estimated using smoking indicated from BC by ART status. For ART users, to evaluate underreporting, prepregnancy smoking was estimated from BC, NASS, or both sources. Effect of prenatal smoking on preterm and mean birthweight (term only) for singleton infants were examined by ART status. RESULTS Maternal smoking prevalence estimates were significantly lower for ART users than nonusers (prepregnancy = 3.2% vs. 16.7%; prenatal = 1.0% vs. 11.1%, p < 0.05). When combining smoking information from BC and NASS, prepregnancy smoking prevalence estimates for ART users could be as high as 4.4% to 6.1%. Adverse effects of smoking on infant outcomes in ART pregnancies were consistent with the effects seen in non-ART pregnancies, specifically decline in infant birthweight and increase in preterm delivery, although association between smoking and preterm was not significant. CONCLUSION A low, but substantial proportion of ART users smoked before and during pregnancy. As ART users are highly motivated to get pregnant, it should be clearly communicated that smoking can decrease fertility and adversely affect pregnancy outcomes. Continued efforts are needed to encourage smoking cessation and maintain tobacco abstinence among all women of reproductive age.
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Affiliation(s)
- Van T Tong
- 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Dmitry M Kissin
- 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Dana Bernson
- 2 Massachusetts Department of Public Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Glenn Copeland
- 3 Michigan Department of Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Sheree L Boulet
- 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Yujia Zhang
- 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Denise J Jamieson
- 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Lucinda J England
- 4 Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
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14
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Dhalwani NN, Boulet SL, Kissin DM, Zhang Y, McKane P, Bailey MA, Hood ME, Tata LJ. Assisted reproductive technology and perinatal outcomes: conventional versus discordant-sibling design. Fertil Steril 2016; 106:710-716.e2. [PMID: 27187051 DOI: 10.1016/j.fertnstert.2016.04.038] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 04/11/2016] [Accepted: 04/25/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To compare risks of adverse perinatal outcomes between assisted reproductive technology (ART) and naturally conceived singleton births using a dual design approach. DESIGN Discordant-sibling and conventional cross-sectional general population comparison. SETTING Not applicable. PATIENT(S) All singleton live births, conceived naturally or via ART. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Birth weight, gestational age, low birth weight, preterm delivery, small for gestational age (SGA), low Apgar score. RESULT(S) A total of 32,762 (0.8%) of 3,896,242 singleton live births in the three states were conceived via ART. In 6,458 sibling pairs, ART-conceived singletons were 33 g lighter (adjusted β = -33.40, 95% confidence interval [CI], -48.60, -18.21) and born half a day sooner (β = -0.58, 95% CI, -1.02, -0.14) than singletons conceived naturally. The absolute risk of low birth weight and preterm birth was 6.8% and 9.7%, respectively, in the ART group and 4.9% and 7.9%, respectively, in the non-ART group. The odds of low birth weight were 33% higher (adjusted odds ratio [aOR] = 1.33; 95% CI, 1.13, 1.56) and 20% higher for preterm birth (aOR = 1.20; 95% CI, 1.07, 1.34). The odds of SGA and low Apgar score were not significantly different in both groups (aOR = 1.22; 95% CI, 0.88, 1.68; and aOR = 0.75; 95% CI, 0.54, 1.05, respectively). Results of conventional analyses were similar, although the magnitude of risk was higher for preterm birth (aOR, 1.51; 95% CI 1.46, 1.56). CONCLUSION(S) Despite some inflated risks in the general population comparison, ART remained associated with an increased likelihood of low birth weight and preterm birth when underlying maternal factors were kept constant using discordant-sibling comparison.
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Affiliation(s)
- Nafeesa N Dhalwani
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom; Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom.
| | - Sheree L Boulet
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dmitry M Kissin
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yujia Zhang
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patricia McKane
- Michigan Department of Health and Human Services, Lansing, Michigan
| | | | - Maria-Elena Hood
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Laila J Tata
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
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15
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Luke S, Sappenfield WM, Kirby RS, McKane P, Bernson D, Zhang Y, Chuong F, Cohen B, Boulet SL, Kissin DM. The Impact of ART on Live Birth Outcomes: Differing Experiences across Three States. Paediatr Perinat Epidemiol 2016; 30:209-16. [PMID: 26913961 PMCID: PMC10976649 DOI: 10.1111/ppe.12287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Research has shown an association between assisted reproductive technology (ART) and adverse birth outcomes. We identified whether birth outcomes of ART-conceived pregnancies vary across states with different maternal characteristics, insurance coverage for ART services, and type of ART services provided. METHODS CDC's National ART Surveillance System data were linked to Massachusetts, Florida, and Michigan vital records from 2000 through 2006. Maternal characteristics in ART- and non-ART-conceived live births were compared between states using chi-square tests. We performed multivariable logistic regression analyses and calculated adjusted odds ratios (aOR) to assess associations between ART use and singleton preterm delivery (<32 weeks, <37 weeks), singleton small for gestational age (SGA) (<5th and <10th percentiles) and multiple birth. RESULTS ART use in Massachusetts was associated with significantly lower odds of twins as well as triplets and higher order births compared to Florida and Michigan (aOR 22.6 vs. 30.0 and 26.3, and aOR 37.6 vs. 92.8 and 99.2, respectively; Pinteraction < 0.001). ART use was associated with increased odds of SGA in Michigan only, and with preterm delivery (<32 and <37 weeks) in all states (aOR range: 1.60, 1.87). CONCLUSIONS ART use was associated with an increased risk of preterm delivery among singletons that showed little variability between states. The number of twins, triplets and higher order gestations per cycle was lower in Massachusetts, which may be due to the availability of insurance coverage for ART in Massachusetts.
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Affiliation(s)
- Sabrina Luke
- College of Public Health, University of South Florida, Tampa, FL
| | | | - Russell S. Kirby
- College of Public Health, University of South Florida, Tampa, FL
| | | | - Dana Bernson
- Massachusetts Department of Public Health, Boston, MA
| | - Yujia Zhang
- Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Bruce Cohen
- Massachusetts Department of Public Health, Boston, MA
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16
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Luke B, Stern JE, Hornstein MD, Kotelchuck M, Diop H, Cabral H, Declercq ER. Is the wrong question being asked in infertility research? J Assist Reprod Genet 2016; 33:3-8. [PMID: 26634257 PMCID: PMC4717139 DOI: 10.1007/s10815-015-0610-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 10/28/2015] [Indexed: 10/22/2022] Open
Abstract
A persistent finding is that assisted reproductive technology (ART) is associated with compromised birth outcomes, including higher risks for prematurity, low birthweight, and congenital malformations, even among singletons. Over the past decade, our research group, the Massachusetts Outcome Study of Assisted Reproductive Technology (MOSART), has evaluated pregnancy and birth outcomes among three groups of women, those women treated with ART, those with indicators of subfertility but without ART treatment, and fertile women. We have also explored the influence of infertility-related diagnoses on outcomes for women and infants. Over the course of our research, we have changed our perspective from an original focus on ART treatment parameters as the primary cause of excess morbidity to one centered instead on the underlying infertility-related diagnoses. This paper summarizes the research findings from our group that support this change in focus for infertility-based research from a primary emphasis on ART treatment to greater attention to the contribution of preexisting pathology underlying the infertility and suggests directions for future analyses.
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Affiliation(s)
- Barbara Luke
- Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, 965 Fee Road, East Fee Hall, Room 628, East Lansing, MI, 48824, USA.
| | - Judy E Stern
- Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Mark D Hornstein
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Milton Kotelchuck
- MassGeneral Hospital for Children, Harvard Medical School, Boston, MA, USA
| | - Hafsatou Diop
- Massachusetts Department of Public Health, Boston, MA, USA
| | - Howard Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Eugene R Declercq
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
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17
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Kotelchuck M, Hoang L, Stern JE, Diop H, Belanoff C, Declercq E. The MOSART database: linking the SART CORS clinical database to the population-based Massachusetts PELL reproductive public health data system. Matern Child Health J 2015; 18:2167-78. [PMID: 24623195 DOI: 10.1007/s10995-014-1465-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Although Assisted Reproductive Technology (ART) births make up 1.6 % of births in the US, the impact of ART on subsequent infant and maternal health is not well understood. Clinical ART treatment records linked to population data would be a powerful tool to study long term outcomes among those treated or not by ART. This paper describes the development of a database intended to accomplish this task. We constructed the Massachusetts Outcomes Study of Assisted Reproductive Technology (MOSART) database by linking the Society of Assisted Reproductive Technologies Clinical Outcomes Reporting System (SART CORS) and the Massachusetts (MA) Pregnancy to Early Life Longitudinal (PELL) data systems for children born to MA resident women at MA hospitals between July 2004 and December 2008. PELL data representing 282,971 individual women and their 334,152 deliveries and 342,035 total births were linked with 48,578 cycles of ART treatment in SART CORS delivered to MA residents or women receiving treatment in MA clinics, representing 18,439 eligible women of whom 9,326 had 10,138 deliveries in this time period. A deterministic five phase linkage algorithm methodology was employed. Linkage results, accuracy, and concordance analyses were examined. We linked 9,092 (89.7 %) SART CORS outcome records to PELL delivery records overall, including 95.0 % among known MA residents treated in MA clinics; 70.8 % with full exact matches. There were minimal differences between matched and unmatched delivery records, except for unknown residency and out-of-state ART site. There was very low concordance of reported use of ART treatment between SART CORS and PELL (birth certificate) data. A total of 3.4 % of MA children (11,729) were identified from ART assisted pregnancies (6,556 singletons; 5,173 multiples). The MOSART linked database provides a strong basis for further longitudinal ART outcomes studies and supports the continued development of potentially powerful linked clinical-public health databases.
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Affiliation(s)
- Milton Kotelchuck
- MGH Center for Child and Adolescent Health Research and Policy, MassGeneral Hospital for Children, 100 Cambridge Street, 15-1545, Boston, MA, 02114, USA,
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18
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Schieve LA, Fountain C, Boulet SL, Yeargin-Allsopp M, Kissin DM, Jamieson DJ, Rice C, Bearman P. Does Autism Diagnosis Age or Symptom Severity Differ Among Children According to Whether Assisted Reproductive Technology was Used to Achieve Pregnancy? J Autism Dev Disord 2015; 45:2991-3003. [PMID: 25997596 PMCID: PMC4553150 DOI: 10.1007/s10803-015-2462-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Previous studies report associations between conception with assisted reproductive technology (ART) and autism. Whether these associations reflect an ascertainment or biologic effect is undetermined. We assessed diagnosis age and initial autism symptom severity among >30,000 children with autism from a linkage study of California Department of Developmental Services records, birth records, and the National ART Surveillance System. Median diagnosis age and symptom severity levels were significantly lower for ART-conceived than non-ART-conceived children. After adjustment for differences in the socio-demographic profiles of the two groups, the diagnosis age differentials were greatly attenuated and there were no differences in autism symptomatology. Thus, ascertainment issues related to SES, not ART per se, are likely the driving influence of the differences we initially observed.
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Affiliation(s)
- Laura A Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, MS E-86, 1600 Clifton Road, Atlanta, GA, 30333, USA,
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19
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Boulet SL, Crawford S, Zhang Y, Sunderam S, Cohen B, Bernson D, McKane P, Bailey MA, Jamieson DJ, Kissin DM. Embryo transfer practices and perinatal outcomes by insurance mandate status. Fertil Steril 2015; 104:403-9.e1. [PMID: 26051096 DOI: 10.1016/j.fertnstert.2015.05.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 04/27/2015] [Accepted: 05/11/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To use linked assisted reproductive technology (ART) surveillance and birth certificate data to compare ET practices and perinatal outcomes for a state with a comprehensive mandate requiring coverage of IVF services versus states without a mandate. DESIGN Retrospective cohort study. SETTING Not applicable. PATIENT(S) Live-birth deliveries ascertained from linked 2007-2009 National ART Surveillance System and birth certificate data for a state with an insurance mandate (Massachusetts) and two states without a mandate (Florida and Michigan). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Number of embryos transferred, multiple births, low birth weight, preterm delivery. RESULT(S) Of the 230,038 deliveries in the mandate state and 1,026,804 deliveries in the nonmandate states, 6,651 (2.9%) and 8,417 (0.8%), respectively, were conceived by ART. Transfer of three or more embryos was more common in nonmandate states, although the effect was attenuated for women 35 years or older (33.6% vs. 39.7%; adjusted relative risk [RR], 1.46; 95% confidence interval [CI], 1.17-1.81) versus women younger than 35 (7.0% vs. 26.9%; adjusted RR, 4.18; 95% CI, 2.74-6.36). Lack of an insurance mandate was positively associated with triplet/higher order deliveries (1.0% vs. 2.3%; adjusted RR, 2.44; 95% CI, 1.81-3.28), preterm delivery (22.6% vs. 30.7%; adjusted RR, 1.31; 95% CI, 1.20-1.42), and low birth weight (22.3% vs. 29.5%; adjusted RR, 1.28; 95% CI, 1.17-1.40). CONCLUSION(S) Compared with nonmandate states, the mandate state had higher overall rates of ART use. Among ART births, lack of an infertility insurance mandate was associated with increased risk for adverse perinatal outcomes.
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Affiliation(s)
- Sheree L Boulet
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Sara Crawford
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yujia Zhang
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Saswati Sunderam
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bruce Cohen
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Dana Bernson
- Massachusetts Department of Public Health, Boston, Massachusetts
| | | | | | - Denise J Jamieson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dmitry M Kissin
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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20
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Dunietz GL, Holzman C, McKane P, Li C, Boulet SL, Todem D, Kissin DM, Copeland G, Bernson D, Sappenfield WM, Diamond MP. Assisted reproductive technology and the risk of preterm birth among primiparas. Fertil Steril 2015; 103:974-979.e1. [PMID: 25707336 PMCID: PMC4515958 DOI: 10.1016/j.fertnstert.2015.01.015] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 01/11/2015] [Accepted: 01/12/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the risk of preterm birth among liveborn singletons to primiparas who conceived with assisted reproductive technology (ART) using four mutually exclusive categories of infertility (female infertility only, male infertility only, female and male infertility, and unexplained infertility) and to examine preterm birth risk along the gestational age continuum. DESIGN Retrospective cohort study. SETTING Not applicable. PATIENT(S) Singletons born to primiparas who conceived with or without ART. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Preterm (<37 weeks' gestation) and preterm/early term birth <39 weeks' gestation). RESULT(S) For the male infertility only, female infertility only, combined male and female infertility, and unexplained infertility groups, ART-conceived singletons were significantly more likely than non-ART singletons to be born preterm: adjusted odds ratio (aOR) 1.24 (95% CI, 1.13, 1.37), aOR 1.60 (95% CI, 1.50, 1.70), aOR 1.49 (95% CI, 1.35, 1.64), and aOR 1.26 (1.12, 1.43) respectively. Among infants whose mothers were diagnosed with infertility, the odds of preterm birth were highest between 28-30 weeks [female infertility only, aOR 1.95 (95% CI, 1.59, 2.39); male and female infertility: 2.21 (95% CI, 1.62, 3.00)] compared with infants in the general population. Within the ART population, singletons of couples with female infertility only were more likely to be born preterm than singletons born to couples with other infertility diagnoses. CONCLUSION(S) Among singleton births to primiparas, those conceived with ART had an increased risk for preterm birth, even when only the male partner had been diagnosed with infertility. The risk of preterm birth for ART-conceived infants whose mothers were diagnosed with infertility included the earliest deliveries.
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Affiliation(s)
- Galit Levi Dunietz
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan.
| | - Claudia Holzman
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan
| | - Patricia McKane
- Michigan Department of Community Health, Maternal and Child Health Section, Lansing, Michigan
| | - Chenxi Li
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan
| | - Sheree L Boulet
- Division of Reproductive Health at Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David Todem
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan
| | - Dmitry M Kissin
- Division of Reproductive Health at Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Glenn Copeland
- Michigan Department of Community Health, Lansing, Michigan
| | - Dana Bernson
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - William M Sappenfield
- Department of Community and Family Health, University of South Florida, Tampa, Florida
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, Georgia
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21
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Fountain C, Zhang Y, Kissin DM, Schieve LA, Jamieson DJ, Rice C, Bearman P. Association between assisted reproductive technology conception and autism in California, 1997-2007. Am J Public Health 2015; 105:963-71. [PMID: 25790396 DOI: 10.2105/ajph.2014.302383] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed the association between assisted reproductive technology (ART) and diagnosed autistic disorder in a population-based sample of California births. METHODS We performed an observational cohort study using linked records from the California Birth Master Files for 1997 through 2007, the California Department of Developmental Services autism caseload for 1997 through 2011, and the Centers for Disease Control and Prevention's National ART Surveillance System for live births in 1997 through 2007. Participants were all 5 926 251 live births, including 48 865 ART-originated infants and 32 922 cases of autism diagnosed by the Department of Developmental Services. We compared births originated using ART with births originated without ART for incidence of autism. RESULTS In the full population, the incidence of diagnosed autism was twice as high for ART as non-ART births. The association was diminished by excluding mothers unlikely to use ART; adjustment for demographic and adverse prenatal and perinatal outcomes reduced the association substantially, although statistical significance persisted for mothers aged 20 to 34 years. CONCLUSIONS The association between ART and autism is primarily explained by adverse prenatal and perinatal outcomes and multiple births.
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Affiliation(s)
- Christine Fountain
- Christine Fountain is with the Department of Sociology and Anthropology, Fordham University, New York, NY. Yujia Zhang, Dmitry M. Kissin, and Denise J. Jamieson are with the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Laura A. Schieve and Catherine Rice are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention. Peter Bearman is with the Interdisciplinary Center for Innovative Theory and Empirics, Columbia University, New York
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22
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Kissin DM, Zhang Y, Boulet SL, Fountain C, Bearman P, Schieve L, Yeargin-Allsopp M, Jamieson DJ. Association of assisted reproductive technology (ART) treatment and parental infertility diagnosis with autism in ART-conceived children. Hum Reprod 2015; 30:454-65. [PMID: 25518976 PMCID: PMC4287306 DOI: 10.1093/humrep/deu338] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 10/29/2014] [Accepted: 11/27/2014] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Are assisted reproductive technology (ART) treatment factors or infertility diagnoses associated with autism among ART-conceived children? SUMMARY ANSWER Our study suggests that the incidence of autism diagnosis in ART-conceived children during the first 5 years of life was higher when intracytoplasmic sperm injection (ICSI) was used compared with conventional IVF, and lower when parents had unexplained infertility (among singletons) or tubal factor infertility (among multiples) compared with other types of infertility. WHAT IS KNOWN ALREADY Some studies found an increased risk of autism among ART-conceived infants compared with spontaneously-conceived infants. However, few studies, and none in the USA, have examined the associations between types of ART procedures and parental infertility diagnoses with autism among ART-conceived children. STUDY DESIGN, SIZE, DURATION Population-based retrospective cohort study using linkages between National ART Surveillance System (NASS) data for 1996-2006, California Birth Certificate data for 1997-2006, and California Department of Developmental Services (DDS) Autism Caseload data for 1997-2011. PARTICIPANTS/MATERIALS, SETTING, METHODS All live born ART-conceived infants born in California in 1997-2006 (n = 42 383) with 5-year observation period were included in the study. We assessed the annual incidence of autism diagnosis documented in DDS, which includes information on the vast majority of persons with autism in California, and the association of autism diagnosis with ART treatment factors and infertility diagnoses. MAIN RESULTS AND THE ROLE OF CHANCE Among ART-conceived singletons born in California between 1997 and 2006, the incidence of autism diagnosis remained at ∼0.8% (P for trend 0.19) and was lower with parental diagnosis of unexplained infertility (adjusted hazard risk ratio [aHRR]; 95% confidence interval: 0.38; 0.15-0.94) and higher when ICSI was used (aHRR 1.65; 1.08-2.52), when compared with cases without these patient and treatment characteristics. Among ART-conceived multiples, the incidence of autism diagnosis between 1997 and 2006 remained at ∼1.2% (P for trend 0.93) and was lower with parental diagnosis of tubal factor infertility (aHRR 0.56; 0.35-0.90) and higher when ICSI was used (aHRR 1.71; 1.10-2.66). LIMITATIONS, REASONS FOR CAUTION Study limitations include imperfect data linkages, lack of data on embryo quality and possible underestimation of autism diagnosis cases. Limitations of the observational study design could affect the analysis by the possibility of residual confounders. Since information about ICSI use was missing for most frozen/thawed embryo transfer cycles, our findings of association of ICSI use and autism diagnosis can only be generalizable to fresh embryo transfer cycles. WIDER IMPLICATIONS OF THE FINDINGS Our study provides additional evidence of the association between some types of ART procedures with autism diagnosis. Additional research is required to explain the increased risk of autism diagnosis with ICSI use, as well as studies on the effectiveness and safety of ICSI.
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Affiliation(s)
- D M Kissin
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Y Zhang
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S L Boulet
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - C Fountain
- Department of Sociology and Anthropology, Fordham University, New York, NY, USA
| | - P Bearman
- Interdisciplinary Center for Innovative Theory and Empirics, Columbia University, New York, NY, USA
| | - L Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - D J Jamieson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Baldwin E, Johnson K, Berthoud H, Dublin S. Linking mothers and infants within electronic health records: a comparison of deterministic and probabilistic algorithms. Pharmacoepidemiol Drug Saf 2014; 24:45-51. [DOI: 10.1002/pds.3728] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 09/05/2014] [Accepted: 09/30/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Eric Baldwin
- Group Health Research Institute; Group Health Cooperative; Seattle WA USA
| | - Karin Johnson
- Group Health Research Institute; Group Health Cooperative; Seattle WA USA
| | - Heidi Berthoud
- Group Health Research Institute; Group Health Cooperative; Seattle WA USA
| | - Sascha Dublin
- Group Health Research Institute; Group Health Cooperative; Seattle WA USA
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Cohen B, Bernson D, Sappenfield W, Kirby RS, Kissin D, Zhang Y, Copeland G, Zhang Z, Macaluso M. Accuracy of assisted reproductive technology information on birth certificates: Florida and Massachusetts, 2004-06. Paediatr Perinat Epidemiol 2014; 28:181-90. [PMID: 24533655 DOI: 10.1111/ppe.12110] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Assisted Reproductive Technology (ART) includes fertility procedures where both egg and sperm are handled in the lab. ART use has increased considerably in recent years, accounting for 47,090 livebirths in the U.S. in 2010. ART increases the probability of multiple gestation births, which are at higher risks than singletons for adverse outcomes. Additionally, ART is associated with a greater risk of complications during pregnancy, labour, and delivery, and increased risk of adverse perinatal outcomes in singleton births. METHODS We merged Florida and Massachusetts birth records from 2004-06 with the National ART Surveillance System (NASS) and using NASS as the gold standard, calculated sensitivity, specificity, and positive predictive value (PPV) of ART reporting on the birth certificates by maternal, infant, and hospital characteristics. We fit random-effects logistic regression models to evaluate simultaneously the association of ART reporting with these predictors while accounting for correlation among births occurring in the same hospital. RESULTS Sensitivity of ART reporting on the birth certificate was 28.9% in Florida and 41.4% in Massachusetts. Specificity was >99% in both states. PPV was 45.5% in Florida and 54.6% in Massachusetts. The odds of ART reporting varied by state and by several maternal and delivery characteristics including age, parity, history of fetal loss, plurality, race/Hispanic ethnicity, delivery payment source, pre-existing conditions, and complications during pregnancy or labour and delivery. CONCLUSIONS There was significant under-reporting of ART procedures on the birth certificates. Using data on ART births identified only from birth certificates yields a biased sample of the population of ART births.
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Affiliation(s)
- Bruce Cohen
- Massachusetts Department of Public Health, Boston, MA
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25
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Grigorescu V, Zhang Y, Kissin DM, Sauber-Schatz E, Sunderam M, Kirby RS, Diop H, McKane P, Jamieson DJ. Maternal characteristics and pregnancy outcomes after assisted reproductive technology by infertility diagnosis: ovulatory dysfunction versus tubal obstruction. Fertil Steril 2014; 101:1019-25. [PMID: 24484993 DOI: 10.1016/j.fertnstert.2013.12.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 12/09/2013] [Accepted: 12/16/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine differences in maternal characteristics and pregnancy outcomes between women with ovulatory dysfunction (OD) and women with tubal obstruction (TO) who underwent assisted reproductive technology (ART). DESIGN Retrospective cohort study. SETTING Centers for Disease Control and Prevention. PATIENT(S) Exposed and nonexposed groups were selected from the 2000-2006 National ART Surveillance System linked with live-birth certificates from three states: Florida, Massachusetts, and Michigan. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Maternal characteristics and pregnancy outcomes, including newborn's health status right after delivery (Apgar score, <7 vs. ≥ 7) as the study outcome of interest, were assessed among women with OD/polycystic ovary syndrome (PCOS) and TO who used ART. RESULT(S) A significantly higher prevalence of women with OD/PCOS were younger (<35 years of age; 65.7% vs. 48.9%), were white (85.4% vs. 74.4%), had higher education (29.4% vs. 15.6%), and experienced diabetes (8.8% vs. 5.3%) compared with those having TO. The odds of having a lower (<7) Apgar score at 5 minutes were almost twice as high among newborns of women with OD/PCOS compared with those with TO (crude odds ratio, 1.86; 95% confidence interval [CI], 1.31, 2.64; adjusted odds ratio, 1.90; 95% CI, 1.30, 2.77). CONCLUSION(S) Women with OD/PCOS who underwent ART have different characteristics and health issues (higher prevalence of diabetes) and infant outcomes (lower Apgar score) compared with women with TO.
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Affiliation(s)
| | - Yujia Zhang
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dmitry M Kissin
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Mithi Sunderam
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Russell S Kirby
- College of Public Health, University of South Florida, Tampa, Florida
| | - Hafsatou Diop
- Massachusetts Department of Public Health, Boston, Massachusetts
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Placzek H, Madoff L. Effect of race/ethnicity and socioeconomic status on pandemic H1N1-related outcomes in Massachusetts. Am J Public Health 2013; 104:e31-8. [PMID: 24228651 DOI: 10.2105/ajph.2013.301626] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We linked hospital discharge and American Community Survey and US Census data to investigate 2009 H1N1 influenza (H1N1)-related outcomes by racial/ethnic groups and socioeconomic status (SES). METHODS We examined the population discharged from any acute care hospital in Massachusetts and calculated rates of intensive care unit (ICU) stay by racial/ethnic and SES groups between April 26 and September 30, 2009. We used logistic regression models to identify predictors of ICU stay. RESULTS Of 4874 H1N1-related hospitalizations, 526 (11%) were admitted to the ICU. Those in less affluent SES groups had lower risk of ICU stay than the most affluent SES group. Compared with Whites, Hispanics had significantly lower risk of 2009 H1N1-related ICU stay (odds ratio = 0.52; 95% confidence interval = 0.32, 0.86). Only 13% of Whites admitted to the ICU were in the lowest SES group, compared with 63% of Hispanics and 43% of Blacks. CONCLUSIONS To our knowledge, this is the first statewide description of 2009 H1N1 influenza-related ICU stays according to racial/ethnic group and SES in the United States. Future work should investigate evidence related to social determinants of health among racial/ethnic groups to reduce disparities in relation to pandemic influenza.
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Affiliation(s)
- Hilary Placzek
- Hilary Placzek is with the Department of Clinical and Population Health Research, University of Massachusetts Medical School, Worcester, and HealthCore, Inc, Andover. Lawrence Madoff is with the Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, and the Division of Epidemiology and Immunization, Massachusetts Department of Public Health, Jamaica Plain
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Mneimneh AS, Boulet SL, Sunderam S, Zhang Y, Jamieson DJ, Crawford S, McKane P, Copeland G, Mersol-Barg M, Grigorescu V, Cohen B, Steele J, Sappenfield W, Diop H, Kirby RS, Kissin, for the States Monitoring A DM. States Monitoring Assisted Reproductive Technology (SMART) Collaborative: Data Collection, Linkage, Dissemination, and Use. J Womens Health (Larchmt) 2013; 22:571-7. [DOI: 10.1089/jwh.2013.4452] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Allison S. Mneimneh
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sheree L. Boulet
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Saswati Sunderam
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Yujia Zhang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Denise J. Jamieson
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sara Crawford
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Glenn Copeland
- Michigan Department of Community Health, Lansing, Michigan
| | | | - Violanda Grigorescu
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bruce Cohen
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - JoAnn Steele
- Florida Department of Health, Tallahassee, Florida
| | - William Sappenfield
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
| | - Hafsatou Diop
- Massachusetts Department of Public Health, Boston, Massachusetts
| | - Russell S. Kirby
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
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