Gestational hypertension in pregnancies supported by infertility treatments: role of infertility, treatments, and multiple gestations.

Abstract

OBJECTIVE:

To investigate the association between infertility treatments and gestational hypertension and preeclampsia.

DESIGN:

Retrospective observational cohort.

SETTING:

General population, United States and Canada.

PATIENT(S):

Five thousand one hundred fifty-one women with non-malformed infants participating in the Slone Epidemiology Center Birth Defects Study between 1998 and 2006.

INTERVENTION(S):

Women were interviewed within 6 months after delivery about sociodemographic and medical factors, about the onset of gestational hypertension and preeclampsia, and about infertility treatments.

MAIN OUTCOME MEASURE(S):

We estimated relative risks and 95% confidence intervals by using unconditional logistic regression.

RESULT(S):

The incidence of gestational hypertension was 8.9% (423/4,762) among women without infertility treatments and was 15.8% (55/349) among women undergoing infertility treatments. Compared with spontaneous pregnancies, the crude relative risk for gestational hypertension in pregnancies resulting from infertility treatments was 1.9 (95% confidence interval, 1.4-2.6). Multivariate adjustment for parity and prepregnancy body mass index resulted in a relative risk of 1.6 (1.1-2.1). Further adjustment for multiple pregnancies, or restriction of the analyses to singleton pregnancies, moved the relative risk to 1.3. Each specific infertility procedure or drug was associated with a similarly elevated risk, which disappeared after adjustment for multiple gestations. Results were similar for preeclampsia.

CONCLUSION(S):

Pregnancies resulting from infertility treatments have a higher incidence of gestational hypertension and preeclampsia than do spontaneous conceptions. This increased risk is largely explained by the higher frequency of multiple gestations.

• Authors: Sonia Hernández-Díaz, Martha M Werler, Allen A Mitchell
• Journal: Fertility and sterility (Fertil Steril) Vol. 88 Issue 2 Pg. 438-45 (Aug 2007) ISSN: 1556-5653 [Electronic] United States
• PMID: 17449034 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Fertility Agents

Topics

• Adult
• Case-Control Studies
• Female
• Fertility Agents (adverse effects, therapeutic use)
• Humans
• Hypertension, Pregnancy-Induced (epidemiology, etiology)
• Incidence
• Infant, Newborn
• Infertility (complications, drug therapy, epidemiology)
• Pre-Eclampsia (epidemiology, etiology)
• Pregnancy
• Pregnancy, Multiple (physiology, statistics & numerical data)
• Retrospective Studies
• Risk Factors