Policy efforts to prevent ART-related preterm birth.
At 12.5%, the preterm birth rate is the highest it has ever been in the US. In tandem with the rise in preterm birth is a dramatic increase in multiple birth rates. The recent trend of delayed maternal age at first birth and the associated use of assisted reproductive technologies (ARTs) have led to the increase in multiple gestation and its attendant increased risk for preterm birth. While ARTs are not responsible for the majority of preterm births, the attributable fraction has increased, is iatrogenic- and preventable. Despite widespread recognition of this problem, the rate of associated twin gestation has not decreased. We offer options for policymakers on several levels--from medical to health systems to societal policy--to decrease ART-related preterm births.
Johnson
Blair
B
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia Presbyterian Medical Center, 622 W. 168th Street, PH-16, New York, NY 10032, USA. ebj2107@columbia.edu
Chavkin
Wendy
W
D004624:Embryo Transfer / Q000009:adverse effects / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D008423:Maternal Age; D009099:Multiple Birth Offspring / Q000706:statistics & numerical data*; D016134:Organizational Policy; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D047928:Premature Birth / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011640:Public Policy; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects* / Q000592:standards / Q000706:statistics & numerical data; D012922:Social Change; D014481:United States / Q000453:epidemiology