What is the risk of hypertensive disorders in pregnancies after assisted reproduction? NTNU HyperAHA hypertension hypertensivedisorders reproduction assistedreproduction reproductivehealth pregnancy
By Dr. Priyom Bose, Ph.D.Sep 29 2022Reviewed by Danielle Ellis, B.Sc. In Western countries, 7% of children are born via assisted reproductive technology . Conventionally, ART is associated with intracytoplasmic sperm injection and in vitro fertilization , which involves fresh embryo transfer . Sometimes, in the case of surplus embryos, they are frozen and can later be thawed and used in subsequent cycles.
Recent sibship analyses revealed that singletons conceived by fresh-ET were smaller for gestational age compared to their naturally conceived siblings. However, singletons conceived after frozen-ET were larger for gestational age compared to naturally conceived siblings. The risk of preterm birth was found to be higher after both ART treatments.
The study period was between 1988 and 2014 for Denmark and 1988 to 2015 for Norway and Sweden. The cohort contained all singleton deliveries from mothers above 20 years of age. After excluding participants who did not fit the criteria of this study, 4,523,028 deliveries from 2,379,130 mothers were included in the final analysis, which contained 78,300 fresh-ET and 18,037 frozen-ET deliveries.
All conception methods exhibited a low prevalence of chronic hypertension. 6.6% of pregnancies after frozen-ET, 8.1% after fresh-ET, and 5.0% after natural conception were associated with preterm delivery. Interestingly, compared to natural conception, pregnancies after frozen-ET and fresh-ET were inclined towards cesarean section delivery. The unadjusted risk of HDP was found in 7.4% of women after frozen-ET, 5.9% after fresh ET, and 4.3% after natural conception.
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