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In‐Hospital Complications in Pregnancies Conceived by Assisted Reproductive Technology

Wu, Pensée; V. Sharma, Garima; S. Mehta, Laxmi; Chew-Graham, Carolyn; P. Lundberg, Gina; A. Nerenberg, Kara; M. Graham, Michelle; C. Chappell, Lucy; T. Kadam, Umesh; P. Jordan, Kelvin; A. Mamas, Mamas

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Garima V. Sharma

Laxmi S. Mehta

Gina P. Lundberg

Kara A. Nerenberg

Michelle M. Graham

Lucy C. Chappell

Umesh T. Kadam


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.


Wu, P., V. Sharma, G., S. Mehta, L., Chew-Graham, C., P. Lundberg, G., A. Nerenberg, K., …A. Mamas, M. (2022). In‐Hospital Complications in Pregnancies Conceived by Assisted Reproductive Technology. Journal of the American Heart Association, 11(5), Article ARTN e022658.

Journal Article Type Article
Acceptance Date Dec 9, 2021
Online Publication Date Feb 22, 2022
Publication Date Mar 1, 2022
Publicly Available Date May 30, 2023
Journal Journal of the American Heart Association
Electronic ISSN 2047-9980
Publisher Wiley Open Access
Peer Reviewed Peer Reviewed
Volume 11
Issue 5
Article Number ARTN e022658
Keywords cardiovascular disease risk factors; in vitro fertilization; pregnancy; prevention
Publisher URL


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