1935-2018 年美国和瑞典高龄产妇生育率的纵向趋势以及与孕产妇死亡率的比较。

IF 2.1 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Human Fertility Pub Date : 2023-12-01 Epub Date: 2023-02-20 DOI:10.1080/14647273.2022.2161075
Jessica Grubman, Marcelle Cedars, Nadia Diamond-Smith
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引用次数: 0

摘要

高龄产妇(AMA,分娩时年龄大于 35 岁)会带来孕产和胎儿风险,尤其是年龄大于 45 岁和非孕期的高龄产妇,但目前还缺乏有关年龄和特定奇数期 AMA 生育率的纵向比较数据。我们利用人类生育率数据库(HFD)这一公开的国际数据库,分析了美国和瑞典 35-54 岁女性从 1935 年到 2018 年的生育率。我们评估了不同年龄段的生育率(ASFR)、总出生人数和AMA生育比例,并将其与同期的孕产妇死亡率进行了比较。在美国,AMA 婴儿的总出生人数始于 20 世纪 70 年代,此后一直呈上升趋势。在 1980 年之前,大多数产妇都是在 5 个或 5 个以上足月分娩的;从那时起,大多数产妇都是在低足月分娩的。2015年,35至39岁女性的ASFR最高,而40至44岁和45至49岁女性的ASFR则在1935年最高,不过最近一直在上升,尤其是低奇偶性女性。1970-2018年期间,美国和瑞典的AMA生育趋势相同,但美国的孕产妇死亡率有所上升,尽管瑞典的孕产妇死亡率仍然很低。虽然已知AMA会导致孕产妇死亡,但这种差异值得进一步考虑。
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Longitudinal trends in fertility in women of advanced maternal age in the United States and Sweden from 1935-2018 and comparison to maternal mortality ratios.

Advanced maternal age (AMA, >35 years at delivery) confers maternal and foetal risks, particularly with age >45 years and nulliparity, but longitudinal comparative data on age- and parity-specific AMA fertility is lacking. We used the Human Fertility Database (HFD), a publicly available, international database, to analyse fertility in US and Swedish women aged 35-54 from 1935 to 2018. Age-specific fertility rates (ASFR), total birth counts, and proportion of AMA births were evaluated across maternal age, parity, and time, and compared to maternal mortality rates during the same time. In the US, total AMA births nadired in the 1970s, and have risen since. Until 1980, most AMA births were to women completing parity 5 or higher; since then, most have been to low parity women. While ASFR in 35 to 39 year olds was highest in 2015, ASFR in women 40-44 and 45-49 were highest in 1935, though they have been rising recently, especially in low-parity women. While the same AMA fertility trends were seen in the US and Sweden from 1970-2018, maternal mortality rates have risen in the US despite remaining low in Sweden. Although AMA is known to contribute to maternal mortality, this discrepancy merits further consideration.

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来源期刊
Human Fertility
Human Fertility OBSTETRICS & GYNECOLOGY-REPRODUCTIVE BIOLOGY
CiteScore
3.30
自引率
5.30%
发文量
50
期刊介绍: Human Fertility is a leading international, multidisciplinary journal dedicated to furthering research and promoting good practice in the areas of human fertility and infertility. Topics included span the range from molecular medicine to healthcare delivery, and contributions are welcomed from professionals and academics from the spectrum of disciplines concerned with human fertility. It is published on behalf of the British Fertility Society. The journal also provides a forum for the publication of peer-reviewed articles arising out of the activities of the Association of Biomedical Andrologists, the Association of Clinical Embryologists, the Association of Irish Clinical Embryologists, the British Andrology Society, the British Infertility Counselling Association, the Irish Fertility Society and the Royal College of Nursing Fertility Nurses Group. All submissions are welcome. Articles considered include original papers, reviews, policy statements, commentaries, debates, correspondence, and reports of sessions at meetings. The journal also publishes refereed abstracts from the meetings of the constituent organizations.
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