Assisted reproductive technology and hypertensive disorders
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Hypertensive disorders of pregnancy (HDP) are one of the most common pregnancy complications and causes of maternal morbidity and mortality. Assisted reproductive technology (ART) has been associated with adverse pregnancy outcomes, including HDP.

Investigators conducted a systematic review and meta-analyses to evaluate the association between ART and HDP or preeclampsia relative to spontaneous conception (SC).

They identified studies from EMBASE, MEDLINE, and Cochrane Library and manually using structured search strategies. Cohort studies that included pregnancies after in vitro fertilization (IVF) with or without intracytoplasmic sperm fertilization (ICSI) relative to SC with HDP or preeclampsia as the outcome of interest were included. The control group was women who conceived spontaneously without ART or fertility medications.

- Compared to SC, IVF/ICSI singleton pregnancies and multiple pregnancies were both associated with higher odds of HDP.

- Singleton pregnancies with oocyte donation had the highest odds of HDP out of all groups analyzed.

- Frozen embryo transfer resulted in higher odds of HDP than fresh embryo transfer.

- The associations between IVF/ICSI pregnancies and SC were similar for preeclampsia. Most interventions had an NNH of 40 to 100, while singleton and multiple oocyte donation pregnancies had particularly low NNH for HDP.

The meta-analysis confirmed that IVF/ICSI pregnancies are at higher odds of HDP and preeclampsia than SC, irrespective of the plurality. The odds were especially high in frozen embryo transfer and oocyte donation pregnancies.

BMC Pregnancy and Childbirth