Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
BMC Pregnancy Childbirth. 2023 Jul 18;23(1):523. doi: 10.1186/s12884-023-05838-5.
Although in vitro fertilization (IVF) can increase the incidence of hypertensive disorders of pregnancy (HDP), the pregnancy outcomes and disease phenotype of HDP in singleton pregnancies conceived via IVF remain unclear.
This retrospective cohort study enrolled 1130 singleton pregnancies with HDP from 2016 to 2020. According to the mode of conception, they were allocated into IVF (n = 102) and natural conception (NC) groups (n = 1028). All IVF pregnancies were subdivided into frozen embryo transfer (FET) group (n = 42) and fresh embryo transfer (ET) group (n = 60). Demographic data, pregnancy outcomes and disease phenotypes of HDP among the groups were compared. The risk factors for severe preeclampsia (PE) and early-onset PE were analyzed.
The incidences of early-onset PE (P<0.001), severe PE (P = 0.016), cesarean section (P<0.001) and preterm births (P = 0.003) in the IVF-HDP group were significantly higher than those in the NC-HDP group, and gestational age at diagnosis of HDP (P = 0.027) and gestational age at delivery (P = 0.004) were earlier and birthweight of the neonates (P = 0.033) were lower in the IVF group. In singleton pregnancies with HDP, IVF was associated with increased risks for both severe PE and early-onset PE (aOR 1.945, 95% CI 1.256, 3.014; and aOR 2.373, 95% CI 1.537, 3.663, respectively), as well as FET, family history of preeclampsia, intrahepatic cholestasis of pregnancy, gestational hypothyroidism and multiparity were associated with increased risks of severe PE and early-onset PE.
In singleton pregnancies with HDP, IVF was associated with an increased incidence of the disease phenotype (severe or early-onset PE), as well as an increased incidence of pregnancy outcomes related to severe PE and early-onset PE.
体外受精（IVF）虽可增加妊娠高血压疾病（HDP）的发生率，但体外受精单胎妊娠的妊娠结局和 HDP 疾病表型仍不清楚。
本回顾性队列研究纳入了 2016 年至 2020 年期间 1130 例 HDP 单胎妊娠。根据受孕方式将其分为 IVF 组（n=102）和自然受孕（NC）组（n=1028）。所有 IVF 妊娠均进一步分为冻融胚胎移植（FET）组（n=42）和新鲜胚胎移植（ET）组（n=60）。比较各组的人口统计学数据、妊娠结局和 HDP 疾病表型。分析重度子痫前期（PE）和早发型 PE 的危险因素。
IVF-HDP 组早发型 PE（P<0.001）、重度 PE（P=0.016）、剖宫产术（P<0.001）和早产（P=0.003）的发生率显著高于 NC-HDP 组，IVF 组 HDP 的诊断孕周（P=0.027）和分娩孕周（P=0.004）更早，新生儿出生体重（P=0.033）更低。在 HDP 单胎妊娠中，IVF 与重度 PE 和早发型 PE 的风险增加相关（aOR 1.945，95%CI 1.256，3.014；和 aOR 2.373，95%CI 1.537，3.663），FET、PE 家族史、妊娠肝内胆汁淤积症、妊娠甲状腺功能减退和多胎妊娠与重度 PE 和早发型 PE 的风险增加相关。
在 HDP 单胎妊娠中，IVF 与疾病表型（重度或早发型 PE）的发生率增加以及与重度 PE 和早发型 PE 相关的妊娠结局发生率增加相关。
