摘要

BACKGROUND: Global, regional, and national estimates of prevalence of and tends in infertility are needed to target prevention and treatment efforts. By applying a consistent algorithm to demographic and reproductive surveys available from developed and developing countries, we estimate infertility prevalence and trends, 1990 to 2010, by country and region. METHODS AND FINDINGS: We accessed and analyzed household survey data from 277 demographic and reproductive health surveys using a consistent algorithm to calculate infertility. We used a demographic infertility measure with live birth as the outcome and a 5-y exposure period based on union status, contraceptive use, and desire for a child. We corrected for biases arising from the use of incomplete information on past union status and contraceptive use. We used a Bayesian hierarchical model to estimate prevalence of and trends in infertility in 190 countries and territories. In 2010, among women 20-44 y of age who were exposed to the risk of pregnancy, 1.9% (95% uncertainty interval 1.7%, 2.2%) were unable to attain a live birth (primary infertility). Out of women who had had at least one live birth and were exposed to the risk of pregnancy, 10.5% (9.5%, 11.7%) were unable to have another child (secondary infertility). Infertility prevalence was highest in South Asia, Sub-Saharan Africa, North Africa/Middle East, and Central/Eastern Europe and Central Asia. Levels of infertility in 2010 were similar to those in 1990 in most world regions, apart from declines in primary and secondary infertility in Sub-Saharan Africa and primary infertility in South Asia (posterior probability [pp] ≥0.99). Although there were no statistically significant changes in the prevalence of infertility in most regions amongst women who were exposed to the risk of pregnancy, reduced child-seeking behavior resulted in a reduction of primary infertility among all women from 1.6% to 1.5% (pp=0.90) and a reduction of secondary infertility among all women from 3.9% to 3.0% (pp>0.99) from 1990 to 2010. Due to population growth, however, the absolute number of couples affected by infertility increased from 42.0 million (39.6 million, 44.8 million) in 1990 to 48.5 million (45.0 million, 52.6 million) in 2010. Limitations of the study include gaps in survey data for some countries and the use of proxies to determine exposure to pregnancy. CONCLUSIONS: We analyzed demographic and reproductive household survey data to reveal global patterns and trends in infertility. Independent from population growth and worldwide declines in the preferred number of children, we found little evidence of changes in infertility over two decades, apart from in the regions of Sub-Saharan Africa and South Asia. Further research is needed to identify the etiological causes of these patterns and trends.

译文

背景: 需要全球、区域和国家对不孕症的患病率和趋势进行估计,以达到预防和治疗的目的。通过将一致的算法应用于发达国家和发展中国家的人口和生殖调查,我们按国家和地区估计了 1990 至 2010年的不孕症患病率和趋势。方法和结果: 我们访问并分析了来自 277 个人口和生殖健康调查的家庭调查数据,使用一致的算法计算不孕症。我们使用了以活产为结局的人口统计学不孕症测量和基于结合状态、避孕药具使用和对孩子的渴望的 5-y 暴露期。我们纠正了因使用关于过去结合状态和避孕药具使用的不完整信息而产生的偏见。我们使用贝叶斯层次模型来估计 190 个国家和地区不孕症的患病率和趋势。2010,在 20-44 岁的女性中,暴露在怀孕风险中的女性占 1.9% (95% 不确定区间为 1.7%,2.2%) 无法实现活产 (原发性不孕)。在至少有过一次活产并面临怀孕风险的妇女中,10.5% (9.5%,11.7%) 无法生育另一个孩子 (继发性不孕)。不孕症患病率在南亚、撒哈拉以南非洲、北非/中东、中欧/东欧和中亚最高。在世界大多数地区,2010年的不孕不育程度与 1990年相似, 除了撒哈拉以南非洲地区原发性和继发性不孕的下降和南亚地区的原发性不孕 (后验概率 [pp] ≥ 0。 99)。尽管在大多数地区,处于怀孕风险的妇女中,不孕症的患病率没有统计学上的显著变化, 减少求子行为导致所有妇女的原发性不孕症从 1.6% 减少到 1.5% (pp = 0.90),所有妇女的继发性不孕症从 3.9% 减少到 3.0%(Pp> 0.99) 从 1990年 18 年 2010年。然而,由于人口增长,受不孕影响的夫妇的绝对数量从 1990年的 4200万 (3960万,4480万) 增加到 2010年的 4850万 (4500万,5260万)。这项研究的局限性包括一些国家的调查数据存在差距,以及使用代用物来确定怀孕风险。结论: 我们分析了人口统计学和生殖家庭调查数据,以揭示不孕症的全球模式和趋势。除了在撒哈拉以南非洲和南亚地区,独立于人口增长和全球首选儿童数量的下降,我们几乎没有发现不孕不育在过去二十年中发生变化的证据。需要进一步的研究来确定这些模式和趋势的病因。

infertility

妇产 不孕不育 疾病
概述  :  

不孕(育)症是一组由多种病因导致的生育障碍状态,是育龄夫妇的生殖健康不良事件。如今随着辅助生殖技术的迅猛发展,已经帮助许多不孕夫妇获得后代,但也引起了一些伦理或法律问题,需要严格管理和规范。对于大多数女性患者而言,盆腔因素和排卵障碍是其不孕的主要病因,但多种病因可同时存在。故诊断时需男、女双方同时就诊,根据病史、排卵功能、输卵管通畅性和男方精液检查明确病因。女性无避孕性生活至少12个月而未孕即称为不孕症,对男性则称为不育症。不孕症分为原发性和继发性两大类,既往从未有过妊娠史,未避孕而从未妊娠

infertility  英 [ˌɪnfɜːˈtɪləti] 美 [ˌɪnfɜːrˈtɪləti]

释    义   n. 不孕症;不肥沃,贫瘠

同根词   infertile   adj. infertile 不肥沃的;不毛的;不结果实的;不能生殖的

例    句   Some infertility experts worry about their health and development.  一些不孕不育专家为他们的健康和发育担忧。

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