Risk for preeclampsia elevated with technology-assisted pregnancies
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NEW ORLEANS — People who became pregnant using assisted reproductive technologies were twice as likely to develop preeclampsia compared with traditional pregnancy, researchers reported at the American College of Cardiology Scientific Session.
“The proportion of technology-assisted pregnancies has doubled in the U.S. over the past two decades,” Ahmad Mustafa, MD, chief resident at Northwell Health in Staten Island, New York, said during a virtual press conference before the meeting.
Technology-assisted pregnancy involves the utilization of assisted reproductive technologies such as intrauterine insemination or in vitro fertilization to achieve pregnancy, Mustafa said. Technology-assisted pregnancies are generally categorized as traditional surrogacy or gestational carrier, Mustafa said. With traditional surrogacy, the person carrying the embryo has a genetic connection to the embryo, whereas with gestational carrier, the person carrying the embryo has no genetic connection to the embryo.
Researchers used the National Inpatient Sample database to assess rates of CV complications, including preeclampsia, arrhythmias, MI, HF, pulmonary edema, venous thromboembolism and gestational diabetes, for 5,874 technology-assisted pregnancies and more than 2.2 million traditional pregnancies from 2016 to 2018.
Rates were higher for supraventricular tachycardia (0.3% vs. 0.1%), conduction abnormalities (0.4% vs. 0.2%), acute pulmonary edema (0.2% vs. 0%), preeclampsia (10.2% vs. 5%) and gestational diabetes (12.1% vs. 7.5%) with technology-assisted pregnancies compared with traditional pregnancies. Moreover, length of hospital stay was longer at 4.1 days compared with 2.7 days.
The researchers then used statistical methods to match technology-assisted pregnancies (n = 5,858) with a subset of the traditional pregnancies (n = 5,858) carried by people with similar age, race and baseline comorbidities. Surrogate carriers were twice as likely to have preeclampsia (OR = 1.9; 95% CI, 1.6-2.2; P < .001) and had a longer length of stay (4.1 vs. 3.1 days; P < .001) compared with traditional pregnancies, Mustafa reported.
In a subgroup analysis that looked at gestational carriers (n = 190) compared with traditional surrogates (n = 5,684), traditional surrogates had elevated risk for preeclampsia (10.4% vs. 5.3%), gestational diabetes (12.2% vs. 6.8%) and longer length of stay (4.2 vs. 2.8 days; P < .05 for all). Traditional surrogates were generally older and had more hypertension.
“Technology-assisted pregnancies are more likely to have preeclampsia and increased length of hospital stay,” Mustafa said during the press conference. “We do recommend that dedicated cardiovascular care needs to be incorporated into the routine follow-up of patients conceiving through assisted reproductive technologies. This will ensure that they receive appropriate care and timely management of any cardiovascular issues that may arise.”
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Mustafa A, et al. 58. Spotlight on Special Topics: Cardio-obstetrics. Presented at: American College of Cardiology Scientific Session; March 4-6, 2023; New Orleans (hybrid meeting).
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