Validity of self-reported use of assisted reproductive technology treatment among women participating in the pregnancy risk assessment monitoring system in five states, 2000
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Objectives: To assess the validity of a question on assisted reproductive technology (ART) incorporated into the Pregnancy Risk Assessment Monitoring System (PRAMS) in 2000. While the intent of the question is to ascertain whether the index infant was conceived using ART, the phrasing was ambiguous for women who had used ART while trying to conceive the index infant but became pregnant after discontinuing treatment. Methods: We compared weighted PRAMS estimates from five states that incorporated the ART question in 2000 with data from the U.S. ART Surveillance System (ART-SS) maintained by the Centers for Disease Control and Prevention (CDC). U.S. medical practices are mandated to report data for every ART procedure to CDC annually; thus, the ART-SS is highly specific and complete. Results: ART use was reported for 156 of the PRAMS births in our study population, representing 4,571 (95% Confidence Limit, 3,452–5,690) births from the total birth cohort in the five states of interest in 2000. For the same maternal residency states and year, 1,768 births were reported to the ART-SS. Thus, we calculate that PRAMS overestimated ART use by 2,803 births. PRAMS estimated 2.59 times as many ART births as reported to the ART-SS. While for singletons, a large excess in estimated births from PRAMS was observed (ratio=3.50), there was little difference between the PRAMS estimates and ART-SS for twin and triplet births. Conclusion: These findings suggest women responding to PRAMS may be reporting past ART use in addition to current. The findings by plurality support this hypothesis.
KeywordsAssisted reproductive technology Pregnancy Validity Survey
We thank the five Pregnancy Risk Assessment Monitoring System (PRAMS) states that contributed data for this analysis. The following PRAMS Coordinators were responsible for coordinating data collection: Alabama—Albert Woolbright, PhD; Illinois—Theresa Sandidge, MA; Maine—Kim Haggan; Nebraska—Jennifer Severe-Oforah; Oklahoma—Dick Lorenz. We also thank Denise D’Angelo from the CDC PRAMS Team, Division of Reproductive Health, Centers for Disease Control and Prevention. The data from the assisted reproductive technology (ART) Surveillance System were collected by the Society for Assisted Reproductive Technology (SART). The SART system is jointly supported by the CDC, SART, and the American Society for Reproductive Medicine (ASRM).
The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the Centers for Disease Control and Prevention.
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