Cyanotic congenital heart disease following fertility treatments in the United States from 2011 to 2014

Heart ◽  
2017 ◽  
Vol 104 (11) ◽  
pp. 945-948 ◽  
Author(s):  
Alireza A Shamshirsaz ◽  
Zhoobin H Bateni ◽  
Haleh Sangi-haghpeykar ◽  
Sara E Arian ◽  
Hadi Erfani ◽  
...  
Keyword(s):  
Congenital Heart ◽  
The United States ◽  
Fertility Treatment ◽  
Gamete Intrafallopian Transfer ◽  
Adjusted Relative Risk ◽  
Treatment Groups ◽  
Live Births ◽  
Fertility Treatments ◽  
Infertility Treatments ◽  
The Usa

ObjectiveTo examine the risk for cyanotic congenital heart diseases (CCHDs) among live births in the USA, resulting from various forms of infertility treatments.MethodsThis study is a cross-sectional analysis of live births in the USA from 2011 to 2014. Infertility treatments are categorised into two of the following groups on birth certificates: assisted reproductive technology (ART) fertility treatment (surgical egg removal; eg, in vitro fertilisation and gamete intrafallopian transfer) and non-ART fertility treatment (eg, medical treatment and intrauterine insemination). We compared the risk for CCHD in ART and non-ART fertility treatment groups with those infants whose mothers received no documented fertility treatment and were naturally conceived (NC).ResultsAmong 14 242 267 live births from 2011 to 2014, a total of 101 494 live births were in the ART and 81 242 resulted from non-ART fertility treatments. CCHD prevalence in ART, non-ART and NC groups were 393/100 892 (0.39%), 210/80 884 (0.26%) and 10 749/14 020 749 (0.08%), respectively. As compared with naturally conceiving infants, risk for CCHD was significantly higher among infants born in ART (adjusted relative risk (aRR) 2.4, 95% CI 2.1 to 2.7) and non-ART fertility treatment groups (aRR 1.9, 95% CI 1.6 to 2.2). Absolute risk increase in CCHD due to ART and non-ART treatments were 0.03% and 0.02%, respectively. A similar pattern was observed when the analysis was restricted to twins, newborns with birth weights under 1500 g and gestational age of less than 32 weeks.ConclusionsOur findings suggest an increased risk for CCHD in infants conceived after all types of infertility treatment.

scholarly journals 2008 financial crisis vs 2020 economic fallout: How COVID-19 might influence fertility treatment and live births

2020 ◽  
Author(s):  
Piotr S. Gromski ◽  
Andrew D.A.C Smith ◽  
Deborah A Lawlor ◽  
Fady I. Sharara ◽  
Scott M Nelson
Keyword(s):  
Live Birth ◽  
Economic Recession ◽  
The United States ◽  
Fertility Treatment ◽  
Live Births ◽  
Fertility Treatments ◽  
Registration Number ◽  
Birth Data ◽  
The Impact ◽  
Financial Recession

AbstractBackgroundThe economic and reproductive medicine response to the COVID-19 pandemic in the United States has reduced the affordability and accessibility of fertility care. We sought to determine the impact of the 2008 financial recession and the COVID-19 recession on fertility treatments and cumulative live-births.MethodsWe examined annual US natality, CDC IVF cycle activity and live birth data from 1999 to 2018 encompassing 3,286,349 treatment cycles, to estimate the age-stratified reduction in IVF cycles undertaken after the 2008 financial recession, with forward quantitative modelling of IVF cycle activity and cumulative live-births for 2020 to 2023.ResultsThe financial recession of 2008 caused a four-year plateau in fertility treatments with a predicted 53,026 (95% CI 49,581 to 56,471) fewer IVF cycles and 16,872 (95% CI 16,713 to 17,031) fewer live births. A similar scale of economic recession would cause 67,386 (95% CI: 61,686 to 73,086) fewer IVF cycles between 2020 and 2023, with women younger than 35 years overall undertaking 22,504 (95% CI 14,320 to 30,690) fewer cycles, as compared to 4,445 (95% CI 3,144 to 5749) fewer cycles in women over the age of 40 years. This equates to overall 25,143 (95% CI: 22,408 to 27,877) fewer predicted live-births from IVF, of which only 490 (95% CI 381 to 601) are anticipated to occur in women over the age of 40 years.ConclusionsThe COVID-19 recession could have a profound impact on US IVF live-birth rates in young women, further aggravating pre-existing declines in total fertility rates.Trial registration numbernot applicable

How Does the Inclusion of Twins Conceived via Fertility Treatments Influence the Results of Twin Studies?

2012 ◽  
Vol 15 (6) ◽  
pp. 746-752 ◽  
Author(s):  
S. Alexandra Burt ◽  
Kelly L. Klump
Keyword(s):  
Twin Studies ◽  
The United States ◽  
Fertility Treatment ◽  
State University ◽  
Behavioral Differences ◽  
Vitro Fertilization ◽  
Fertility Treatments ◽  
Control And Prevention ◽  
Twin Families

Rates of twinning have risen dramatically over the last 30 years, from 1 in 53 births in 1980 to 1 in 30 births in 2009 (Martin et al. (January 2012). Three decades of twin births in the United States, 1980–2009. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Health Statistics). This increase is largely attributable to increases in the use of fertility treatments (i.e., ovulation induction and in vitro fertilization) combined with delays in parenthood. Although this increase means that more twins are available for recruitment into twin studies, it also has potential consequences for the heritability estimates obtained in these studies. This study sought to evaluate this possibility, making use of the ongoing Michigan Twins Project (N = 7,261 families with twins aged 3–17 years), an arm of the Michigan State University Twin Registry. Results revealed that, on average, twins conceived via fertility treatments had lower rates of behavior problems than those conceived naturally, although these behavioral differences could be explained largely by demographic and socio-economic differences across the two types of twin families. Twin similarity did not meaningfully differ across fertility treatment status. We thus conclude that estimates of genetic and environmental influences obtained from twin studies over the last 10–15 years are more or less unaffected by the inclusion of twins conceived via fertility treatments in their samples.

A Skeletalized Representation of the Total Cavopulmonary Connection

2007 ◽  
Author(s):  
Resmi Krishnankuttyrema ◽  
Lakshmi Prasad Dasi ◽  
Kerem Pekkan ◽  
Kartik Sundareswaran ◽  
Hiroumi D. Kitajima ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Single Ventricle ◽  
Venous Return ◽  
Right Heart ◽  
Live Births ◽  
Correction Technique ◽  
The Usa ◽  
Systemic Venous Return ◽  
The Right ◽  
Cavopulmonary Connection

Single ventricle congenital heart problems are reported for 2 out of every 1000 live births in the USA. In these cases, mixing of oxygenated and deoxygenated blood occurs in the heart causing severe cyanosis. The Fontan repair is a 3-stage palliative surgical correction technique performed during infancy. Its aim is to restore normal oxygen saturation by directly connecting the systemic venous return to the lungs and bypassing the right heart [1].

In search of real autonomy for fertility patients

2014 ◽  
Vol 10 (3) ◽  
pp. 243-250 ◽  
Author(s):  
Josephine Johnston ◽  
Michael K. Gusmano ◽  
Pasquale Patrizio
Keyword(s):  
United States ◽  
Insurance Coverage ◽  
The United States ◽  
Fertility Treatment ◽  
Success Rates ◽  
Policy And Practice ◽  
Insurance Benefits ◽  
Fertility Treatments ◽  
Financial Pressure ◽  
Double Embryo Transfer

AbstractNearly one in eight infants in the United States is born preterm. A variety of factors are associated with preterm birth, including multiplicity. In the United States fertility treatments are currently associated with high rates of multiplicity, but these rates could be reduced significantly if changes can be made to fertility treatment policy and practice. These include reducing the financial pressure on patients to prioritize pregnancy chances over safety by expanding insurance coverage and altering the way we calculate success rates and insurance benefits so that two consecutive single embryo transfers is equivalent to one double embryo transfer.

Adult Congenital Heart Disease

2019 ◽  
pp. 96-110
Author(s):  
Carly Peterson ◽  
Denise Joffe
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
The United States ◽  
Full Spectrum ◽  
Live Births ◽  
Complex Patients ◽  
Adult Congenital ◽  
Specific Expertise

The incidence of congenital heart disease is about 1 in 150 live births. In the United States, there are comprehensive healthcare programs that care for the pediatric patient with congenital heart disease; however, there are far fewer resources available for the adult patient. In fact, the majority of adult congenital heart disease patients are cared for in centers without specific expertise in congenital heart disease, which often results in worse outcomes for many of these complex patients. Therefore, it is preferable for patients with anything more than simple congenital heart disease to be treated in centers with specialized programs that have a full spectrum of providers. This chapter will review some of the medical, anesthetic and surgical challenges in caring for these patients.

P–773 Infertility treatment and the risk of small for gestational age births: a population-based study in the United States

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
H Glatthorn ◽  
M Sauer ◽  
J Brandt ◽  
C Ananth
Keyword(s):  
United States ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
The United States ◽  
Infertility Treatment ◽  
Unmeasured Confounding ◽  
Live Births ◽  
The Us ◽  
Infertility Treatments ◽  
The Impact

Abstract Study question What is the association between infertility treatments and small for gestational age (SGA) births? Summary answer Women who conceived pregnancies with any infertility treatment had a decreased risk of SGA <10th, <5th and <3rd percentiles compared to naturally conceived pregnancies. What is known already Assisted reproductive technology (ART) and other infertility treatments have long been associated with an increased risk of SGA births, which confers a greater risk of perinatal morbidity and mortality compared to appropriate for gestational age births. Study design, size, duration This is a cross-sectional study of 16,836,228 births in the United States (US) between 2015–2019. The exposure group included women who underwent any infertility treatment, including ART and prescribed fertility enhancing medications. The comparison group included those who had naturally conceived pregnancies. The primary outcome was SGA birth, defined as sex-specific birthweight <10th percentile for gestational age. Secondary outcomes included SGA <5th and <3rd percentile births. Participants/materials, setting, methods Pregnant subjects (n = 16,836,228) in the US who delivered non-malformed, singleton live births between 24–44 weeks’ gestational age. We estimated risk of SGA births in relation to any infertility treatment from fitting log-linear Poisson regression models with robust variance. Risk ratios (RR) and 95% confidence intervals (CI) were estimated as the effect measure before and after adjusting for confounders. We also performed a sensitivity analysis to correct for potential non-differential exposure misclassification and unmeasured confounding biases. Main results and the role of chance During the study period, 1.4% (n = 231,177) of non-malformed singleton live births resulted from infertility treatments (0.8% ART and 0.6% fertility enhancing medications). Of these, 9.4% (n = 21,771) of pregnancies conceived with infertility treatment were complicated by SGA <10th percentile compared to 11.9% (n = 1,755,925) of naturally conceived pregnancies. For pregnancies conceived with infertility treatment versus naturally conceived pregnancies, the adjusted RR for SGA <10th percentile was 1.07 (95% CI 1.06, 1.08). However, after correction for misclassification bias and unmeasured confounding, infertility treatment was found to be protective for SGA and conferred a 27% reduced risk of SGA <10th percentile (bias-corrected RR 0.73, 95% CI 0.53, 0.85). These trends were similar for analyses stratified by exposure to ART and fertility enhancing medications and secondary SGA outcomes, including SGA <5th and <3rd percentile. Limitations, reasons for caution All information collected on infertility treatment relies on self-reporting by patients and recording by hospital staff at the time of delivery, which likely resulted in underreporting of infertility treatments. Additionally, we cannot determine the impact of interventions that were not recorded, such as intrauterine insemination (IUI). Wider implications of the findings: Compared to naturally conceived pregnancies, exposure to infertility treatment is associated with reduction in the risk of SGA births. These findings, which are contrary to some published reports, likely reflect changes in the modern practice of infertility care in the US, and importantly, robust analysis of the national data. Trial registration number Not applicable

Emigrant Psychoanalysts in the USA and the FBI Archives

2004 ◽  
Vol 6 (1) ◽  
pp. 75-92 ◽  
Author(s):  
James E. Goggin
Keyword(s):  
United States ◽  
Civil Rights ◽  
National Socialism ◽  
Cultural Context ◽  
Due Process ◽  
The United States ◽  
External Threats ◽  
The Usa ◽  
The Rich ◽  
New Nation

Interest in the fate of the German psychoanalysts who had to flee Hitler's Germany and find refuge in a new nation, such as the United States, has increased. The ‘émigré research’ shows that several themes recur: (1) the theme of ‘loss’ of one's culture, homeland, language, and family; and (2) the ambiva-lent welcome these émigrés received in their new country. We describe the political-social-cultural context that existed in the United States during the 1930s, 1940s and 1950s. Documentary evidence found in the FBI files of three émigré psychoanalysts, Clara Happel, Martin Grotjahn, and Otto Fenichel, are then presented in combination with other source material. This provides a provisional impression of how each of these three individuals experienced their emigration. As such, it gives us elements of a history. The FBI documents suggest that the American atmosphere of political insecurity and fear-based ethnocentric nationalism may have reinforced their old fears of National Socialism, and contributed to their inclination to inhibit or seal off parts of them-selves and their personal histories in order to adapt to their new home and become Americanized. They abandoned the rich social, cultural, political tradition that was part of European psychoanalysis. Finally, we look at these elements of a history in order to ask a larger question about the appropriate balance between a liberal democratic government's right to protect itself from internal and external threats on the one hand, or crossover into the blatant invasion of civil rights and due process on the other.

Sandra Ramos Revisited

2020 ◽  
Vol 2 (4) ◽  
pp. 32-54
Author(s):  
Silvia Spitta
Keyword(s):  
United States ◽  
The United States ◽  
Ancient Greek ◽  
Graphic Arts ◽  
Left Behind ◽  
The World ◽  
The Usa ◽  
Political Choices ◽  
The Rich

Sandra Ramos (b. 1969) is one of the few artists to reflect critically on both sides of the Cuban di-lemma, fully embodying the etymological origins of the word in ancient Greek: di-, meaning twice, and lemma, denoting a form of argument involving a choice between equally unfavorable alternatives. Throughout her works she shines a light on the dilemmas faced by Cubans whether in Cuba or the United States, underlining the bad personal and political choices people face in both countries. During the hard 1990s, while still in Havana, the artist focused on the traumatic one-way journey into exile by thousands, as well as the experience of profound abandonment experienced by those who were left behind on the island. Today she lives in Miami and operates a studio there as well as one in Havana. Her initial disorientation in the USA has morphed into an acerbic representation and critique of the current administration and a deep concern with the environmental collapse we face. A buffoonlike Trumpito has joined el Bobo de Abela and Liborio in her gallery of comic characters derived from the rich Cuban graphic arts tradition where she was formed. While Cuba is now represented as a rotten cake with menacing flies hovering over it ready to pounce, a bombastic Trumpito marches across the world stage, trampling everything underfoot, a dollar sign for a face.

Russian Federation and the United States of America: geostrategic directions to manage the Ukrainian crisis

2019 ◽  
pp. 123
Author(s):  
Attarid Awadh Abdulhameed
Keyword(s):  
United States ◽  
European Union ◽  
National Security ◽  
Russian Federation ◽  
United States Of America ◽  
The United States ◽  
The European Union ◽  
The Usa ◽  
Ukrainian Crisis ◽  
Zero Sum

Ukrainia Remains of huge importance to Russian Strategy because of its Strategic importance. For being a privileged Postion in new Eurasia, without its existence there would be no logical resons for eastward Expansion by European Powers.  As well as in Connection with the progress of Ukrainian is no less important for the USA (VSD, NDI, CIA, or pentagon) and the European Union with all organs, and this is announced by John Kerry. There has always ben Russian Fear and Fear of any move by NATO or USA in the area that it poses a threat to  Russians national Security and its independent role and in funence  on its forces especially the Navy Forces. There for, the Crisis manyement was not Zero sum game, there are gains and offset losses, but Russia does not accept this and want a Zero Sun game because the USA. And European exteance is a Foot hold in Regin Which Russian sees as a threat to its national security and want to monopolize control in the strategic Qirim.

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