TY - JOUR
T1 - In-Hospital Complications in Pregnancies Conceived by Assisted Reproductive Technology
AU - Wu, Pensée
AU - Sharma, Garima V.
AU - Mehta, Laxmi S.
AU - Chew-Graham, Carolyn A.
AU - Lundberg, Gina P.
AU - Nerenberg, Kara A.
AU - Graham, Michelle M.
AU - Chappell, Lucy C.
AU - Kadam, Umesh T.
AU - Jordan, Kelvin P.
AU - Mamas, Mamas A.
N1 - Funding Information:
Dr Wu is funded by a National Institute for Health Research Transitional Research Fellowship (TRF-2017-10-005). Drs Chew-Graham and Jordan are partially funded by West Midlands NIHR Applied Research Collaborations. Dr Chappell is funded by a National Institute for Health Research Professorship (RP-2014-05-019). Dr Sharma is supported by the Blumenthal Scholarship in Preventive Cardiology at Johns Hopkins.
Publisher Copyright:
© 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Background Assisted reproductive technology (ART) has emerged as a common treatment option for infertility, a problem that affects an estimated 48 million couples worldwide. Advancing maternal age with increasing prepregnancy cardiovascular risk factors, such as chronic hypertension, obesity, and diabetes, has raised concerns about pregnancy complications associated with ART. However, in-hospital complications following pregnancies conceived by ART are poorly described. Methods and Results To assess the patient characteristics, obstetric outcomes, vascular complications and temporal trends of pregnancies conceived by ART, we analyzed hospital deliveries conceived with or without ART between January 1, 2008, and December 31, 2016, from the United States National Inpatient Sample database. We included 106 248 deliveries conceived with ART and 34 167 246 deliveries conceived without ART. Women who conceived with ART were older (35 versus 28 years; P<0.0001) and had more comorbidities. ART-conceived pregnancies were independently associated with vascular complications (acute kidney injury: adjusted odds ratio [aOR], 2.52; 95% CI 1.99-3.19; and arrhythmia: aOR, 1.65; 95% CI, 1.46-1.86), and adverse obstetric outcomes (placental abruption: aOR, 1.57; 95% CI, 1.41-1.74; cesarean delivery: aOR, 1.38; 95% CI, 1.33-1.43; and preterm birth: aOR, 1.26; 95% CI, 1.20-1.32), including in subgroups without cardiovascular disease risk factors or without multifetal pregnancies. Higher hospital charges ($18 705 versus $11 983; P<0.0001) were incurred compared with women who conceived without ART. Conclusions Pregnancies conceived by ART have higher risks of adverse obstetric outcomes and vascular complications compared with spontaneous conception. Clinicians should have detailed discussions on the associated complications of ART in women during prepregnancy counseling.
AB - Background Assisted reproductive technology (ART) has emerged as a common treatment option for infertility, a problem that affects an estimated 48 million couples worldwide. Advancing maternal age with increasing prepregnancy cardiovascular risk factors, such as chronic hypertension, obesity, and diabetes, has raised concerns about pregnancy complications associated with ART. However, in-hospital complications following pregnancies conceived by ART are poorly described. Methods and Results To assess the patient characteristics, obstetric outcomes, vascular complications and temporal trends of pregnancies conceived by ART, we analyzed hospital deliveries conceived with or without ART between January 1, 2008, and December 31, 2016, from the United States National Inpatient Sample database. We included 106 248 deliveries conceived with ART and 34 167 246 deliveries conceived without ART. Women who conceived with ART were older (35 versus 28 years; P<0.0001) and had more comorbidities. ART-conceived pregnancies were independently associated with vascular complications (acute kidney injury: adjusted odds ratio [aOR], 2.52; 95% CI 1.99-3.19; and arrhythmia: aOR, 1.65; 95% CI, 1.46-1.86), and adverse obstetric outcomes (placental abruption: aOR, 1.57; 95% CI, 1.41-1.74; cesarean delivery: aOR, 1.38; 95% CI, 1.33-1.43; and preterm birth: aOR, 1.26; 95% CI, 1.20-1.32), including in subgroups without cardiovascular disease risk factors or without multifetal pregnancies. Higher hospital charges ($18 705 versus $11 983; P<0.0001) were incurred compared with women who conceived without ART. Conclusions Pregnancies conceived by ART have higher risks of adverse obstetric outcomes and vascular complications compared with spontaneous conception. Clinicians should have detailed discussions on the associated complications of ART in women during prepregnancy counseling.
KW - cardiovascular disease risk factors
KW - in vitro fertilization
KW - pregnancy
KW - prevention
UR - http://www.scopus.com/inward/record.url?scp=85125554105&partnerID=8YFLogxK
U2 - 10.1161/JAHA.121.022658
DO - 10.1161/JAHA.121.022658
M3 - Article
C2 - 35191320
AN - SCOPUS:85125554105
SN - 2047-9980
VL - 11
SP - e022658
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 5
M1 - e022658
ER -
