Increased incidence of gestational hypertension and preeclampsia after assisted reproductive technology treatment

After assisted reproductive technology (ART), mothers had a 17% increased likelihood of gestational hypertension and preeclampsia compared with non-ART mothers, which was likely associated with the ART mothers’ multiple pregnancies.

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Authors

Yueping A. Wang, Ph.D., Abrar A. Chughtai, Ph.D., Cynthia M. Farquhar, M.D., Wendy Pollock, Ph.D., Kei Lui, M.D., Elizabeth A. Sullivan, M.D.

Volume 105, Issue 4, Pages 920-927

Abstract

Objective:

To determine the association between assisted reproductive technology (ART) treatment and the rate of combined gestational hypertension (GH), preeclampsia (PE).

Design:

Retrospective population study.

Setting:

Not applicable.

Patient(s):

596,520 mothers (3.6% ART mothers) who gave birth between 2007 and 2011.

Intervention(s):

Not applicable.

Main Outcome Measure(s):

Comparison of the rate of GH/PE for ART and non-ART mothers, with odds ratio (OR), adjusted odds ratio (AOR), and 95% confidence interval (CI) used to assess the association between ART and GH/PE.

Result(s):

The overall rate of GH/PE was 4.3%, with 6.4% for ART mothers and 4.3% for non-ART mothers. The rate of GH/PE was higher for mothers of twins than singletons (12.4% vs. 5.7% for ART mothers; 8.6% vs. 4.2% for non-ART mothers). The ART mothers had a 17% increased odds of GH/PE compared with the non-ART mothers (AOR 1.17; 95% CI, 1.10–1.24). After stratification by plurality, the difference in GH/PE rates between ART and non-ART mothers was not statistically significant, with AOR 1.05 (95% CI, 0.98–1.12) for mothers of singletons and AOR 1.10 (95% CI, 0.94–1.30) for mothers of twins.

Conclusion(s):

The changes in AOR after stratification indicated that multiple pregnancies after ART are the single most likely explanation for the increased rate of GH/PE among ART mothers. The lower rate of GH/PE among mothers of singletons compared with mothers of twins suggests that a policy to minimize multiple pregnancies after ART may reduce the excess risk of GH/PE due to ART treatment.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)02202-5/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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