Pensee Wu p.wu@keele.ac.uk
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
Authors
Garima V. Sharma
Laxmi S. Mehta
Carolyn Chew-Graham c.a.chew-graham@keele.ac.uk
Gina P. Lundberg
Kara A. Nerenberg
Michelle M. Graham
Lucy C. Chappell
Umesh T. Kadam
Kelvin Jordan k.p.jordan@keele.ac.uk
Mamas Mamas m.mamas@keele.ac.uk
Abstract
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.
Citation
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. https://doi.org/10.1161/JAHA.121.022658
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 |
DOI | https://doi.org/10.1161/JAHA.121.022658 |
Keywords | cardiovascular disease risk factors; in vitro fertilization; pregnancy; prevention |
Publisher URL | https://www.ahajournals.org/doi/10.1161/JAHA.121.022658 |
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IVF manuscript JAHA R1 clean.docx
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Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
Supplemental materials JAHA R1 clean.docx
(112 Kb)
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Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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