Common infertility treatments may increase risks for pregnancy, vascular complications
Date:
February 22, 2022
Source:
American Heart Association
Summary:
Women who become pregnant with assisted reproductive technology
(infertility treatment) are at higher risk for vascular
complications, such as irregular heartbeat and kidney injury, as
well as pregnancy complications, including placental separation,
cesarean delivery or preterm birth, compared to women who conceive
without infertility treatment, according to a new study. Risks
for pregnancy and vascular complications were highest among women
who became pregnant with assisted reproductive technology and had
pre-existing cardiovascular risk factors.
FULL STORY ========================================================================== Women who conceive with assisted reproductive technology (infertility treatment) may be at increased risk for vascular and pregnancy-related complications, according to new research published today in a special Go
Red for Women(R) issue of the Journal of the American Heart Association,
an open access, peer-reviewed journal of the American Heart Association.
========================================================================== Assisted reproductive technology, also known as ART, is the umbrella
term for infertility treatments in which eggs or embryos are handled to
improve the odds of pregnancy. These treatments may involve administering medication to control timing of ovulation, as well as procedures such
as in vitro fertilization (IVF) or intracytoplasmic sperm injection,
during which a woman's eggs are surgically retrieved and fertilized in
a laboratory before being implanted back into her uterus. According to
2019 statistics from the U.S. Centers for Disease Control and Prevention,
the use of assisted reproductive technology has more than doubled during
the past decade. More than 2% of infants born in the U.S. every year
are conceived with assisted reproductive technology. Since 1978, ART
has contributed to the birth of more than 5 million infants worldwide.
"Older women are increasingly turning to assisted reproductive technology.
However, advancing maternal age -- specifically being age 35 and older -
- increases the risk of having or developing conditions, such as chronic
high blood pressure, that increase the risk of pregnancy complications," according to study author Pense'e Wu, M.B.Ch.B., M.D., senior lecturer
and honorary consultant obstetrician and subspecialist in Maternal
Fetal Medicine at Keele University School of Medicine in Staffordshire,
United Kingdom.
"Adverse pregnancy complications such as high blood pressure
during pregnancy have now been established as risk factors for
future cardiovascular disease," Wu said. "All of this has raised
concerns about adverse pregnancy outcomes associated with assisted
reproductive technology, yet studies on the topic are few and have
inconsistent findings. A better understanding of the potential impact of assisted reproductive technology on women's risks for cardiovascular-
and pregnancy-related outcomes will help inform women considering
assisted reproductive technology and is valuable after birth to develop cardiovascular risk reduction strategies." For this study, researchers examined data from the U.S. National Inpatient Sample, which contains all hospital discharges between January 1, 2008, and December 31, 2016. They extracted records for all delivery admissions and specifically records
that noted the use of assisted reproductive technology, as well as cardiovascular and pregnancy-related complications. The researchers also evaluated hospital costs, length of stay and more. The study included more
than 106,000 deliveries conceived with assisted reproductive technology
and more than 34,167,000 deliveries conceived without ART.
The analysis found:
* Women who conceived with assisted reproductive technology were
older, at
an average age of 35 years compared to 28 years for those who
conceived without ART.
* Those who conceived with assisted reproductive technology also
had more
pre-existing health conditions, such as chronic hypertension,
obesity and diabetes.
* Women with assisted reproductive technology-conceived pregnancies
were
more than 2.5 times more likely to suffer acute kidney damage,
also known as acute kidney failure, and they were also found to
have a 65% higher risk for arrhythmia (irregular heartbeat).
* Assisted reproductive technology-conceived pregnancy was associated
with
a 57% greater likelihood of placental abruption, a serious
complication in which the placenta separates from the lining of
the uterus; a 38% increased risk of Cesarean delivery; and a 26%
higher risk for preterm birth.
* The increased risks were present even among the women having ART
who did
not have pre-existing cardiovascular risk factors.
* Hospital charges for women who conceived with assisted reproductive
technology were an average $18,705 compared to $11,983 for those
who conceived without ART.
"We were surprised that assisted reproductive technology was independently associated with these complications, as opposed to being associated with
only the existence of pre-existing health conditions or only among older
women undergoing infertility treatment," Wu said.
The study highlights the importance of counseling patients who are
considering assisted reproductive technology about health and pregnancy,
as well as postpartum-related risks.
"Especially patients with existing cardiovascular risk factors should be counseled about the potentially long-term cardiovascular implications
and risks associated with ART," Wu said. "It's important for women to
know that assisted reproductive technology carries a higher risk of
pregnancy complications, which require close monitoring, particularly
during delivery. Primary and specialist health care professionals should
ensure these risks are communicated and strategies to mitigate them are discussed and implemented." A study limitation is its retrospective
nature, meaning it is an examination of data that was recorded for
reasons other than research, therefore, there may be errors, such as misclassification or misdiagnosis.
"Future research should examine how optimizing cardiovascular risk prior
to assisted reproductive technology impacts pregnancy complications and long-term cardiovascular health," Wu said.
The National Institute for Health Research and Blumenthal Scholarship
in Preventive Cardiology at Johns Hopkins funded this study.
========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.
========================================================================== Journal Reference:
1. Pense'e Wu, Garima V. Sharma, Laxmi S. Mehta, Carolyn A.
Chew‐Graham, Gina P. Lundberg, Kara A. Nerenberg, Michelle M.
Graham, Lucy C. Chappell, Umesh T. Kadam, Kelvin P. Jordan, Mamas A.
Mamas. In‐Hospital Complications in Pregnancies Conceived
by Assisted Reproductive Technology. Journal of the American Heart
Association, 2022; DOI: 10.1161/JAHA.121.022658 ==========================================================================
Link to news story:
https://www.sciencedaily.com/releases/2022/02/220222085604.htm
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