Racial and ethnic disparities in assisted reproductive technology pregnancy and live birth rates within body mass index categories Fertility and Sterility
doi:10.1016/j.fertnstert.2010.12.035 | How to Cite or Link Using DOI
Barbara Luke Sc.D., M.P.H.a, b, Corresponding Author Contact Information, E-mail The Corresponding Author, Morton B. Brown Ph.D.c, Judy E. Stern Ph.D.d, Stacey A. Missmer Sc.D.e, f, g, Victor Y. Fujimoto M.D.h and Richard Leach M.D.a
a Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, Michigan
b Department of Epidemiology, Michigan State University, East Lansing, Michigan
c Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
d Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
e Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
f Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
g Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, Massachusetts
h Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California
Objective To evaluate the effect of maternal race and ethnicity within body mass index (BMI) categories on assisted reproduction technology (ART) pregnancy and live birth rates.
Design Historical cohort study.
Setting Clinic-based data.
Patient(s) 31,672 ART embryo transfers from the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System for 2007, limited to women with documented race, ethnicity, height, and weight, with women grouped as white, Asian, Hispanic, or black and by BMI.
Main Outcome Measure(s) Failure to achieve a clinical intrauterine gestation and failure to achieve a live birth as adjusted odds ratios within BMI categories overall with normal-weight women as the reference group, and by race and ethnicity with white women as the reference group.
Result(s) Failure to achieve a clinical intrauterine gestation was significantly more likely among obese women overall (1.22), normal-weight and obese Asian women (1.36 and 1.73, respectively), normal-weight Hispanic women (1.21), and overweight and obese black women (1.34 and 1.47, respectively). Among women who did conceive, failure to achieve a live birth was significantly more likely among overweight and obese women overall (1.16 and 1.27, respectively), overweight and obese Asian women (1.56 and 2.20, respectively) and Hispanic women (1.57 and 1.76, respectively), and normal-weight and obese black women (1.45 and 1.84, respectively).
Conclusion(s) These findings indicate significant disparities in pregnancy and live birth rates by race and ethnicity, even within BMI categories.
A SART Writing Group. Supported by the Society for Assisted Reproductive Technologies (SART).
Corresponding Author Contact InformationCorrespondence: Barbara Luke, Sc.D., M.P.H., Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, B227 West Fee Hall, East Lansing, Michigan 48824.
“While 85 percent of white women who carried their babies for at least 22 weeks eventually gave birth, the same was true for only about 80 percent of both Asian and Hispanic women and 76 percent of black women.”
“Luke's team also speculates that there could be a role for vitamin D deficiency, which is more common in darker-skinned people than whites. Vitamin D deficiency has been linked to an increased risk of bacterial vaginosis, an infection that can up the chances of complications during pregnancy.”
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