Predicting Live Birth, Preterm Delivery, and Low Birth Weight in Infants Born from In Vitro Fertilisation A Prospective Study of 144,018 Treatment Cycles 英文参考文献.docVIP

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Predicting Live Birth, Preterm Delivery, and Low Birth Weight in Infants Born from In Vitro Fertilisation A Prospective Study of 144,018 Treatment Cycles 英文参考文献.doc

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Predicting Live Birth, Preterm Delivery, and Low Birth Weight in Infants Born from In Vitro Fertilisation A Prospective Study of 144,018 Treatment Cycles 英文参考文献

PredictingLiveBirth,PretermDelivery,andLowBirth WeightinInfantsBornfromInVitroFertilisation:A ProspectiveStudyof144,018TreatmentCycles ScottM.Nelson1*,DebbieA.Lawlor2* 1CentreforPopulationandHealthSciences,UniversityofGlasgow,Glasgow,Scotland,UnitedKingdom,2MRCCentreforCausalAnalysisinTranslationalEpidemiology, SchoolofSocialandCommunityMedicine,UniversityofBristol,Bristol,England,UnitedKingdom Abstract Background:Theextenttowhichbaselinecouplecharacteristicsaffecttheprobabilityoflivebirthandadverseperinatal outcomesafterassistedconceptionisunknown. MethodsandFindings:WeutilisedtheHumanFertilisationandEmbryologyAuthoritydatabasetoexaminethepredictors oflivebirthinallinvitrofertilisation(IVF)cyclesundertakenintheUKbetween2003and2007(n=144,018).Weexamined thepotentialclinicalutilityofavalidatedmodelthatpre-datedtheintroductionofintracytoplasmicsperminjection(ICSI)as comparedtoanovelmodel.Forthosetreatmentcyclesthatresultedinalivesingletonbirth(n=24,226),wedetermined theassociatesofpotentialriskfactorswithpretermbirth,lowbirthweight,andmacrosomia.Theoverallrateofatleastone livebirthwas23.4per100cycles(95%confidenceinterval[CI]23.2–23.7).Inmultivariablemodelstheoddsofatleastone live birth decreased with increasing maternal age, increasing duration of infertility, a greater number of previously unsuccessfulIVFtreatments,useofownoocytes,necessityforasecondorthirdtreatmentcycle,orifitwasnotunexplained infertility.Theassociationofownversusdonoroocytewithreducedoddsoflivebirthstrengthenedwithincreasingageof themother.ApreviousIVFlivebirthincreasedtheoddsoffuturesuccess(OR1.58,95%CI1.46–1.71)morethanthatofa previousspontaneouslivebirth(OR1.19,95%CI0.99–1.24);p-valuefordifferenceinestimate,0.001.UseofICSIincreased theoddsoflivebirth,andmalecausesofinfertilitywereassociatedwithreducedoddsoflivebirthonlyincoupleswhohad notreceivedICSI.Predictionoflivebirthwasfeasiblewithmoderatediscriminationandexcellentcalibration;calibrationwas markedlyimprovedinthenovelcomparedtotheestablis