{"id":111,"title":"Contribution of in vitro fertilization to multiple births in South Korea: a nationwide cohort study","title_zh":"体外受精对韩国多胎出生的贡献：一项全国性队列研究","url":"https://pubmed.ncbi.nlm.nih.gov/42971170","doi":"10.4178/epih.e2026058","pmid":"42971170","journal":"Epidemiol Health","kind":"paper","lang":"en","published_at":"2026-10-26T00:00:00+00:00","fetched_at":"2026-11-08T03:43:53+00:00","authors":["Kim S","Kim T","Oh JW","Oh SY","Choe SA"],"primary_topic":"art-clinical","topics":[{"slug":"art-clinical","score":6.0,"hits":["in vitro fertilization","ivf","single embryo transfer"]},{"slug":"industry","score":1.0,"hits":["insurance coverage"]}],"topic_score":6.0,"preference_score":5.0,"preference_labels":["可转化到 ART 实验室的发现"],"llm_score":80.0,"final_score":85.0,"score_dims":{"novelty":65,"rigor":90,"impact":82,"relevance":95,"translation":80},"recommend_reason":"基于全国保险链接队列的大样本研究，量化了IVF对多胎出生的归因贡献并揭示年龄差异，对ART临床策略与单胚胎移植政策具有直接参考价值。","keywords":["体外受精","多胎妊娠","人群归因分数","选择性单胚胎移植","全国队列","韩国"],"selected":1,"story_id":329,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该研究利用韩国国民健康保险服务母子链接数据库，纳入2018年10月至2023年12月共403,708例分娩，分析IVF对多胎出生的贡献。IVF分娩占16.2%，由2018年9.4%升至2023年22.6%；IVF分娩多胎率21.9%，非IVF为1.9%，校正RR为8.67。多胎出生归因于IVF的人群归因分数为55.4%，40-49岁组达66.1%，30-34岁组为46.8%。结论认为韩国超过一半多胎出生可归因于IVF，支持推广选择性单胚胎移植。","summary":"OBJECTIVES: Multiple births expose mothers and infants to disproportionate risks and incur substantial healthcare costs. We quantified the contribution of in vitro fertilization (IVF) to multiple births after universal national insurance coverage for IVF was introduced in South Korea. METHODS: This retrospective cohort study used the Korean National Health Insurance Service Mother-Child Linked Database and included 403,708 deliveries from October 2018 to December 2023. IVF exposure was identified from procedure claims, and plurality was determined from linked infant records. We estimated the adjusted relative risk (RR) of multiple births for IVF versus non-IVF deliveries and the population-attributable fraction (PAF) of multiple births attributable to IVF, overall and by age group. RESULTS: Of 403,708 deliveries, 65,442 (16.2%) involved IVF; this proportion increased from 9.4% in 2018 to 22.6% in 2023. Multiple births occurred in 21.9% of IVF deliveries and 1.9% of non-IVF deliveries. The overall adjusted RR for IVF was 8.67 (95% confidence interval [CI]: 8.40-8.94). Age-specific adjusted RRs were highest in women aged 25-29 years (12.37; 95% CI: 11.09-13.80) and lowest in those aged 40-49 years (7.43; 95% CI: 6.68-8.26). The overall PAF was 55.4%, driven largely by women aged 40-49 years (66.1%). In women aged 30-34 years, the PAF was 46.8%. CONCLUSION: IVF accounts for more than half of multiple births in South Korea, with a substantial contribution among women aged ≤35 years. These findings support policies that promote elective single embryo transfer.","interpretation_basis":null,"fulltext_status":"non_oa","interpretation":null,"fulltext":{"available":false,"status":"non_oa","reason":"Europe PMC 未收录免费全文（非 OA，或该来源不在 Europe PMC 全文范围内，如 bioRxiv 预印本）：isOpenAccess=False, inEPMC=False","pmcid":null,"license":null,"chars":0,"source":"Europe PMC","fetched_at":"2026-11-08T04:19:51+00:00"}}