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

Yueping A Wang; Abrar A Chughtai; Cynthia M Farquhar; Wendy Pollock; Kei Lui; Elizabeth A Sullivan

doi:10.1016/j.fertnstert.2015.12.024

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

Fertil Steril. 2016 Apr;105(4):920-926.e2. doi: 10.1016/j.fertnstert.2015.12.024. Epub 2016 Jan 11.

Authors

Yueping A Wang¹, Abrar A Chughtai², Cynthia M Farquhar³, Wendy Pollock⁴, Kei Lui², Elizabeth A Sullivan⁵

Affiliations

¹ Faculty of Health, University of Technology Sydney, Ultimo, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia. Electronic address: alex.wang@uts.edu.au.
² School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
³ Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
⁴ Mercy Hospital for Women, La Trobe University, Melbourne, Victoria, Australia.
⁵ Faculty of Health, University of Technology Sydney, Ultimo, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.

PMID: 26780118
DOI: 10.1016/j.fertnstert.2015.12.024

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): A total of 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.

Keywords: Assisted reproductive technology; gestational hypertension; preeclampsia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cohort Studies
Female
Humans
Hypertension, Pregnancy-Induced / diagnosis
Hypertension, Pregnancy-Induced / epidemiology
Hypertension, Pregnancy-Induced / etiology
Incidence
Population Surveillance* / methods
Pre-Eclampsia / diagnosis*
Pre-Eclampsia / epidemiology*
Pre-Eclampsia / etiology
Pregnancy
Pregnancy, Multiple
Reproductive Techniques, Assisted / adverse effects
Reproductive Techniques, Assisted / trends*
Retrospective Studies
Risk Factors
Treatment Outcome