Dior Uri P, Laufer Neri, Chill Henry H, Granovsky-Grisaru Sorina, Yagel Simcha, Yaffe Haim, Gielchinsky Yuval
Department of Obstetrics and Gynecology, Hadassah Medical Center and Hebrew University-Hadassah Medical School, P.O. Box 12000, 91120, Jerusalem, Israel.
Department of Obstetrics and Gynecology, Shaare-Zedek Medical Center and Hebrew University Medical School, Jerusalem, Israel.
Arch Gynecol Obstet. 2018 May;297(5):1293-1299. doi: 10.1007/s00404-017-4616-1. Epub 2018 Feb 12.
The aim of this study was to evaluate the risk of preeclampsia in women of advanced age who conceived through donated oocytes as compared with natural conceptions.
A historical prospective study of singleton live births of parturients ≥ 45 years of age at four university hospitals was conducted. For the purpose of the study, the population was divided by the mode of conception into two groups: oocyte donation and natural conception. The main outcome variable in this study was preeclampsia. Secondary outcomes included pregnancy-induced hypertension and Small for Gestational Age.
Two hundred and seventy pregnancies were achieved naturally and 135 women conceived by oocyte donation. Mean age at delivery for the natural conception and oocyte donation groups was 45.7 and 47.8, respectively. Preeclampsia complicated 3 out of 270 (1.1%) natural conception pregnancies and 17 out of 135 (12.6%) oocyte donation conceptions. After adjusting for confounders, oocyte donation pregnancies were found to be associated with a 12-fold increased risk for preeclampsia (P = 0.001). Among oocyte donation pregnancies, the risk of preeclampsia was not affected by parity or age.
A substantially increased risk for preeclampsia was found in oocyte donation pregnancies, suggesting that the foreign oocyte may play a specific biologic role in the development of preeclampsia after the age of 45.
本研究旨在评估高龄女性通过捐赠卵母细胞受孕与自然受孕相比发生先兆子痫的风险。
对四所大学医院中年龄≥45岁的单胎活产产妇进行了一项历史性前瞻性研究。为了本研究的目的，将研究人群按受孕方式分为两组：卵母细胞捐赠组和自然受孕组。本研究的主要结局变量是先兆子痫。次要结局包括妊娠高血压和小于胎龄儿。
自然受孕270例，135名女性通过卵母细胞捐赠受孕。自然受孕组和卵母细胞捐赠组的平均分娩年龄分别为45.7岁和47.8岁。先兆子痫在270例自然受孕妊娠中有3例（1.1%）发生，在135例卵母细胞捐赠受孕中有17例（12.6%）发生。在对混杂因素进行校正后，发现卵母细胞捐赠妊娠发生先兆子痫的风险增加了12倍（P = 0.001）。在卵母细胞捐赠妊娠中，先兆子痫的风险不受产次或年龄的影响。
卵母细胞捐赠妊娠发生先兆子痫的风险显著增加，提示外来卵母细胞可能在45岁以后先兆子痫的发生中发挥特定的生物学作用。
