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Maternal Racial and Ethnic Disparities in Neonatal Birth Outcomes With and Without Assisted Reproduction.

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.

journal_name

Obstet Gynecol

journal_title

Obstetrics and gynecology

authors

Crawford S,Joshi N,Boulet SL,Bailey MA,Hood ME,Manning SE,McKane P,Kirby RS,Kissin DM,Jamieson DJ,States Monitoring Assisted Reproductive Technology (SMART) Collaborative.

doi

10.1097/AOG.0000000000002031

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

1022-1030

issue

eissn

0029-7844

issn

1873-233X

pii

00006250-201706000-00009

journal_volume

129

pub_type

杂志文章

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Maternal Racial and Ethnic Disparities in Neonatal Birth Outcomes With and Without Assisted Reproduction.