Ben-Yaakov R Djaoui, Kessous R, Shoham-Vardi I, Sergienko R, Pariente G, Sheiner E
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Am J Perinatol. 2016 Dec;33(14):1388-1393. doi: 10.1055/s-0036-1582444. Epub 2016 May 9.
The objective of this study was to investigate whether patients who undergo fertility treatments (ovulation induction or in vitro fertilization) have an increased risk for future maternal cardiovascular morbidity. A population-based study compared the incidence of long-term cardiovascular morbidity in a cohort of women with and without a previous exposure to fertility treatments. Deliveries occurred during a 25-year period, with a mean follow-up of 11.7 years. Women with known cardiovascular disease and congenital cardiovascular malformations diagnosed before the index pregnancy and multiple pregnancies were excluded. During the study period, 99,291 patients met the inclusion criteria; 4.1% ( = 4,153) occurred in patients with exposure to fertility treatments. Patients with exposure to fertility treatments did not have higher rates of cardiovascular morbidity. Using a Kaplan-Meier survival curve, patients with an exposure to fertility treatments had no higher cumulative incidence of cardiovascular hospitalizations. Using a Cox proportional hazards model, adjusted for confounders such as preeclampsia, diabetes mellitus, and obesity, exposure to fertility treatments remained unassociated with cardiovascular hospitalizations (adjusted hazard ratio = 1.1; 95% confidence interval, 0.9-1.3; = 0.441). In our population, during a mean follow-up period of 11.7, results showed no increased risk for cardiovascular morbidity in women undergoing fertility treatments.
本研究的目的是调查接受生育治疗（诱导排卵或体外受精）的患者未来发生孕产妇心血管疾病的风险是否增加。一项基于人群的研究比较了一组有过生育治疗暴露史和无此暴露史的女性长期心血管疾病的发病率。分娩发生在25年期间，平均随访11.7年。排除了在本次妊娠前被诊断出患有已知心血管疾病和先天性心血管畸形以及多胎妊娠的女性。在研究期间，99291名患者符合纳入标准；4.1%（n = 4153）发生在接受生育治疗的患者中。接受生育治疗的患者心血管疾病发病率并不更高。使用Kaplan-Meier生存曲线，接受生育治疗的患者心血管住院累积发病率并不更高。使用Cox比例风险模型，对诸如先兆子痫、糖尿病和肥胖等混杂因素进行校正后，生育治疗暴露与心血管住院仍无关联（校正风险比 = 1.1；95%置信区间，0.9 - 1.3；P = 0.441）。在我们的人群中，在平均11.7年的随访期内，结果显示接受生育治疗的女性心血管疾病发病风险并未增加。
