Monitoring births conceived with infertility therapies using Massachusetts pilot PRAMS and birth certificates

APHA Scientific Session and Event Listing

Emily Lu, MPH, Wanda Barfield, MD, MPH, Hafsatou Diop, MD, MPH, and Nancy Wilber, EdD. Statistics & Evaluation, Massachusetts Dept. of Public Health, 250 Washington Street, Fifth Floor, Boston, MA 02108, 6176245517, emily.lu@state.ma.us

In 2002, Massachusetts (MA) had the highest assisted reproductive technology (ART) use per capita. Monitoring infertility therapy (IFT)-conceived births is an emerging priority. MA offers a unique opportunity to compare two surveillance systems for IFT: the Pilot Project for Pregnancy Risk Assessment Monitoring System (PRAMS) and MA birth certificates (BC). Objective: To assess PRAMS' potential to evaluate IFT information currently collected through BC. During the 3-month PRAMS pilot study, a random sample of 480 resident women was selected with a recent live birth (Jan. - Mar. 2005). Data was weighted for non-response. IFT included fertility drugs (FD) and ART (e.g. in vitro fertilization). Descriptive and bivariate analyses compared prevalence rates of PRAMS responses to linked BC information, using Chi-square statistics with 95% confidence intervals (CI). The PRAMS pilot response rate was 72.5% (348/480). Overall, IFT's prevalence was lower on BC than on PRAMS for ART use [2.7% (CI: 2.5, 2.9) vs. 7.8% (CI: 4.3, 11.3)], FD use [0.8% (CI: 0.7, 1.0) vs. 5.6% (CI: 2.8, 8.5)], and total IFT use [3.1% (CI: 2.9, 3.4) vs. 12.7% (CI: 8.5, 16.8)]. For women ≥35, the IFT prevalence was 6.7% on BC vs. 14.6% on PRAMS. For women <35, the IFT prevalence was 2.0% on BC vs. 11.6% on PRAMS. Younger women using IFT were captured less well on BC. MA pilot PRAMS findings suggest under-reporting of IFT' births on MA BC, particularly among younger women. Self-reported data such as PRAMS may be useful in improving the understanding of pregnancy outcomes associated with IFT.

Learning Objectives:

Describe two surveillance systems tracking births conceived through infertility therapies.
Discuss the potential of PRAMS to evaluate infertility therapy information collected through birth certificates.
Identify possible biases in reporting through birth certificates.

Keywords: Pregnancy, Reproductive Health

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation

Creating better MCH data

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA