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Risk factors associated with pre-eclampsia in pregnancies conceived by ART

  • Yan Li
    Affiliations
    Center for Reproductive Medicine, Shandong University, Jinan 250021, China

    The Key Laboratory of Reproductive Endocrinology of Ministry of Education, and National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan 250021, China

    Department of Obstetrics and Gynecology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
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  • Shigang Zhao
    Affiliations
    Center for Reproductive Medicine, Shandong University, Jinan 250021, China

    The Key Laboratory of Reproductive Endocrinology of Ministry of Education, and National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan 250021, China
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  • Yunhai Yu
    Affiliations
    Department of Obstetrics and Gynecology, The Second Hospital of Shandong University, Jinan 250021, China
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  • Chunling Ma
    Affiliations
    Department of Obstetrics and Gynecology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
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  • Ye Zheng
    Affiliations
    Center for Reproductive Medicine, Shandong University, Jinan 250021, China

    The Key Laboratory of Reproductive Endocrinology of Ministry of Education, and National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan 250021, China

    Center for Reproductive Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266003, China
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  • Yue Niu
    Affiliations
    Center for Reproductive Medicine, Shandong University, Jinan 250021, China

    The Key Laboratory of Reproductive Endocrinology of Ministry of Education, and National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan 250021, China
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  • Daimin Wei
    Correspondence
    Corresponding authors.
    Affiliations
    Center for Reproductive Medicine, Shandong University, Jinan 250021, China

    The Key Laboratory of Reproductive Endocrinology of Ministry of Education, and National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan 250021, China
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  • Jinlong Ma
    Correspondence
    Corresponding authors.
    Affiliations
    Center for Reproductive Medicine, Shandong University, Jinan 250021, China

    The Key Laboratory of Reproductive Endocrinology of Ministry of Education, and National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan 250021, China
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Published:September 17, 2019DOI:https://doi.org/10.1016/j.rbmo.2019.09.006

      Abstract

      Research question

      What are the factors associated with the increased incidence of pre-eclampsia in pregnancies conceived through IVF using autologous oocytes?

      Design

      A nested case–control study from the combined cohort of three multicentre randomized trials comparing fresh to frozen embryo transfer, including women who achieved clinical pregnancy after the first embryo transfer. Multivariable logistic regression was used to assess the effect of baseline characteristics, ovarian response parameters, type of fertilization, type of embryo transfer, and number of gestational sacs on the risk of pre-eclampsia.

      Results

      There were 2965 clinical pregnancies and 90 women were diagnosed with pre-eclampsia. Twin gestations (odds ratio [OR] 2.34, 95% confidence interval [CI] 1.50–3.66), mean arterial pressure (OR 1.04, 95% CI 1.01–1.07), frozen embryo transfer (OR 2.06, 95% CI 1.27–3.35), body mass index (BMI) (OR 1.10, 95% CI 1.02–1.18), progesterone level on the day of human chorionic gonadotrophin trigger (OR 1.53, 95% CI 1.07–2.20), and the total dose of gonadotrophin (OR 0.999, 95% CI 0.999–1.000, P = 0.037) were associated with the risk of pre-eclampsia. When the analysis was confined to women who underwent frozen embryo transfer, twin gestations (OR 2.44, 95% CI 1.43–4.18), BMI (OR 1.13, 95% CI 1.03–1.23) and the total dose of gonadotrophin (OR 0.999, 95% CI 0.999–1.000, P = 0.014) were still related to the risk of pre-eclampsia. The embryo stage at transfer was not included in the final models.

      Conclusions

      Frozen embryo transfer was an independent risk factor of pre-eclampsia in assisted reproductive technology. The high ovarian response may also increase the risk of pre-eclampsia. The embryo stage at transfer was not related to the risk of pre-eclampsia.

      Keywords

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      Biography

      Dr Yan Li is pursuing her MD at the Center for Reproductive Medicine of Shandong University, which is one of the largest IVF centres in China. Her major research interests are periconception, pregnancy and child outcomes.
      Key message
      For women receiving assisted reproductive technology treatment, frozen embryo transfer was an independent risk factor of pre-eclampsia. The high ovarian response may also contribute to the risk of pre-eclampsia. The embryo stage at transfer was not related to the risk of pre-eclampsia. Further studies are needed to evaluate the underlying mechanism.