Hypertensive disorders of pregnancy and infertility treatment: a population-based survey among United States women

Monseur, Brent; Morris, J.W.; Hipp, Heather S.; Berghella, Vincenzo

doi:10.1007/s10815-019-01490-1

Cited by 9 publications

(8 citation statements)

References 35 publications

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“…Even worse than over- or under-reporting, a number of known complications of ART are, even today, still not being registered systematically, such as accidental loss of gametes and embryos (not registered at all), infections and bleedings (recorded only by EIM) and maternal death (recorded annually only by EIM). Complications during ongoing pregnancies achieved with ART, such as hypertensive disorders after infertility treatment ( Monseur et al , 2019 ), are not being recorded systematically by any register. The health status of the infants is recorded only at the moment of birth, although minor and major malformations or health impairments are more often determined during further infant development.…”

Section: Discussionmentioning

confidence: 99%

20 years of the European IVF-monitoring Consortium registry: what have we learned? A comparison with registries from two other regions

et al. 2020

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STUDY QUESTION How has the performance of the European regional register of the European IVF-monitoring Consortium (EIM)/European Society of Human Reproduction and Embryology (ESHRE) evolved from 1997 to 2016, as compared to the register of the Centres for Disease Control and Prevention (CDC) of the USA and the Australia and New Zealand Assisted Reproduction Database (ANZARD)? SUMMARY ANSWER It was found that coherent and analogous changes are recorded in the three regional registers over time, with a different intensity and pace, that new technologies are taken up with considerable delay and that incidental complications and adverse events are only recorded sporadically. WHAT IS KNOWN ALREADY European data on ART have been collected since 1997 by EIM. Data collection on ART in Europe is particularly difficult due to its fragmented political and legal landscape. In 1997, approximately 78.1% of all known institutions offering ART services in 23 European countries submitted data and in 2016 this number rose to 91.8% in 40 countries. STUDY DESIGN, SIZE, DURATION We compared the changes in European ART data as published in the EIM reports (2001–2020) with those of the USA, as published by CDC, and with those of Australia and New Zealand, as published by ANZARD. PARTICIPANTS/MATERIALS, SETTING, METHODS We performed a retrospective analysis of the published EIM data sets spanning the 20 years observance period from 1997 to 2016, together with the published data sets of the USA as well as of Australia and New Zealand. By comparing the data sets in these three large registers, we analysed differences in the completeness of the recordings together with differences in the time intervals on the occurrence of important trends in each of them. Effects of suspected over- and under-reporting were also compared between the three registers. X2 log-rank analysis was used to assess differences in the data sets. MAIN RESULTS AND THE ROLE OF CHANCE During the period 1997–2016, the numbers of recorded ART treatments increased considerably (5.3-fold in Europe, 4.6-fold in the USA, 3.0-fold in Australia and New Zealand), while the number of registered treatment modalities rose from 3 to 7 in Europe, from 4 to 10 in the USA and from 5 to 8 in Australia and New Zealand, as published by EIM, CDC and ANZARD, respectively. The uptake of new treatment modalities over time has been very different in the three registers. There is a considerable degree of underreporting of the number of initiated treatment cycles in Europe. The relationship between IVF and ICSI and between fresh and thawing cycles evolved similarly in the three geographical areas. The freeze-all strategy is increasingly being adopted by all areas, but in Europe with much delay. Fewer cycles with the transfer of two or more embryos were reported in all three geographical areas. The delivery rate per embryo transfer in thawing cycles bypassed that in fresh cycles in the USA in 2012, in Australia and New Zealand in 2013, but not yet in Europe. As a result of these changing approaches, fewer multiple deliveries have been reported. Since 2012, the most documented adverse event of ART in all three registers has been premature birth (<37 weeks). Some adverse events, such as maternal death, ovarian hyperstimulation syndrome, haemorrhage and infections, were only recorded by EIM and ANZARD. LIMITATIONS, REASONS FOR CAUTION The methods of data collection and reporting were very different among European countries, but also among the three registers. The better the legal background on ART surveillance, the more complete are the data sets. Until the legal obligation to report is installed in all European countries together with an appropriate quality control of the submitted data the reported numbers and incidences should be interpreted with caution. WIDER IMPLICATIONS OF THE FINDINGS The growing number of reported treatments in ART, the higher variability in treatment modalities and the rising contribution to the birth rates over the last 20 years point towards the increasing impact of ART. High levels of completeness in data reporting have been reached, but inconsistencies and inaccuracies still remain and need to be identified and quantified. The current trend towards a higher diversity in treatment modalities and the rising impact of cryostorage, resulting in improved safety during and after ART treatment, require changes in the organization of surveillance in ART. The present comparison must stimulate all stakeholders in ART to optimize surveillance and data quality assurance in ART. STUDY FUNDING/COMPETING INTEREST(S) This study has no external funding and all costs are covered by ESHRE. There are no competing interests. TRIAL REGISTRATION NUMBER N/A.

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Section: Discussionmentioning

confidence: 99%

20 years of the European IVF-monitoring Consortium registry: what have we learned? A comparison with registries from two other regions

et al. 2020

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“…The use of assisted reproductive technology (ART) has approximately doubled in the past decade, and roughly 2% of all live births in the US involve some method of ART . Although treatments involved are generally safe and well tolerated with a low propensity for severe complications, a growing body of evidence points to certain adverse pregnancy and medical outcomes associated with infertility treatments . Consequently, closer attention has been paid recently to these possible adverse outcomes, including heart disease and stroke.…”

Section: Introductionmentioning

confidence: 99%

Risk of Stroke Hospitalization After Infertility Treatment

Sachdev,

Yamada,

Lee

et al. 2023

JAMA Netw Open

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ImportanceStroke accounts for 7% of pregnancy-related deaths in the US. As the use of infertility treatment is increasing, many studies have sought to characterize the association of infertility treatment with the risk of stroke with mixed results.ObjectiveTo evaluate the risk of hospitalization from hemorrhagic and ischemic strokes in patients who underwent infertility treatment.Design, Setting, and ParticipantsThis population-based, retrospective cohort study used data abstracted from the Nationwide Readmissions Database, which stores data from all-payer hospital inpatient stays from 28 states across the US, from 2010 and 2018. Eligible participants included individuals aged 15 to 54 who had a hospital delivery from January to November in a given calendar year, and any subsequent hospitalizations from January to December in the same calendar year of delivery during the study period. Statistical analysis was performed between November 2022 and April 2023.ExposureHospital delivery after infertility treatment (ie, intrauterine insemination, assisted reproductive technology, fertility preservation procedures, or use of a gestational carrier) or after spontaneous conception.Main Outcomes and MeasuresThe primary outcome was hospitalization for nonfatal stroke (either ischemic or hemorrhagic stroke) within the first calendar year after delivery. Secondary outcomes included risk of stroke hospitalization at less than 30 days, less than 60 days, less than 90 days, and less than 180 days post partum. Cox proportional hazards regression models were used to estimate associations, which were expressed as hazard ratios (HRs), adjusted for confounders. Effect size estimates were corrected for biases due to exposure misclassification, selection, and unmeasured confounding through a probabilistic bias analysis.ResultsOf 31 339 991 patients, 287 813 (0.9%; median [IQR] age, 32.1 [28.5-35.8] years) underwent infertility treatment and 31 052 178 (99.1%; median [IQR] age, 27.7 [23.1-32.0] years) delivered after spontaneous conception. The rate of stroke hospitalization within 12 months of delivery was 37 hospitalizations per 100 000 people (105 patients) among those who received infertility treatment and 29 hospitalizations per 100 000 people (9027 patients) among those who delivered after spontaneous conception (rate difference, 8 hospitalizations per 100 000 people; 95% CI, −6 to 21 hospitalizations per 100 000 people; HR, 1.66; 95% CI, 1.17 to 2.35). The risk of hospitalization for hemorrhagic stroke (adjusted HR, 2.02; 95% CI, 1.13 to 3.61) was greater than that for ischemic stroke (adjusted HR, 1.55; 95% CI, 1.01 to 2.39). The risk of stroke hospitalization increased as the time between delivery and hospitalization for stroke increased, particularly for hemorrhagic strokes. In general, these associations became larger for hemorrhagic stroke and smaller for ischemic stroke following correction for biases.Conclusions and RelevanceIn this cohort study, infertility treatment was associated with an increased risk of stroke-related hospitalization within 12 months of delivery; this risk was evident as early as 30 days after delivery. Timely follow-up in the immediate days post partum and continued long-term follow-up should be considered to mitigate stroke risk.

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“…Our results mirrored these findings, with 16% and 29% of case women reporting hypertension and genitourinary infections, respectively. These percentages are higher than those reported among pregnant women in the U.S, where approximately 7–15% of pregnant women report hypertension (Bornstein, Eliner, Chervenak, & Grünebaum, 2020; Fisher et al, 2018; Monseur, Morris, Hipp, & Berghella, 2019) and 9–17% of pregnant women report genitourinary infections (Howley et al, 2018; Whitehead, Callaghan, Johnson, & Williams, 2009). However, we were only able to calculate these percentages among case women, who may have a higher baseline risk of hypertension and genitourinary infections even without HHA.…”

Section: Discussionmentioning

confidence: 77%

Maternal hereditary hemolytic anemia and birth defects in the National Birth Defects Prevention Study

Papadopoulos

Fisher

Howley

et al. 2022

Birth Defects Research

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Objectives Hereditary hemolytic anemia (HHA) results from genetic mutations that cause red blood cell abnormalities. Little research exists on the relationship between HHA and birth defects. Using data from the National Birth Defects Prevention Study (NBDPS), we described characteristics of HHA‐exposed women and estimated associations between HHA during pregnancy and specific birth defects. Methods The NBDPS was a population‐based, case–control study of major birth defects and included pregnancies with estimated delivery dates from October 1997 through December 2011. Participants were ascertained from hospital discharge lists or birth defect registries at 10 sites. Trained interviewers collected information about pregnancy exposures via telephone questionnaire. We described characteristics among HHA‐exposed women and calculated crude odds ratios and exact 95% confidence intervals for defects with ≥3 exposed cases. Results Among 31 HHA‐exposed women (28 cases/3 controls), 13 (42%) reported sickle cell anemia, 17 (55%) reported thalassemia, and one (3%) reported hereditary spherocytosis. The average age at delivery for HHA‐exposed case women was 27.3 years (range: 17–38). The majority (82%) of HHA‐exposed case women reported additional conditions during pregnancy, including hypertension, genitourinary infections, and respiratory illnesses. Additionally, 93% of case women reported using medication during pregnancy. Among the 28 cases, 18 (64%) had isolated birth defects. The defects with ≥3 exposed cases were anencephaly, atrial septal defect, gastroschisis, and cleft palate. Except for anencephaly, the 95% confidence intervals for all estimates were close to or included the null. Conclusion This hypothesis‐generating study adds to the sparse literature on the association between HHA and birth defects.

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Hypertensive disorders of pregnancy and infertility treatment: a population-based survey among United States women

Cited by 9 publications

References 35 publications

20 years of the European IVF-monitoring Consortium registry: what have we learned? A comparison with registries from two other regions

20 years of the European IVF-monitoring Consortium registry: what have we learned? A comparison with registries from two other regions

Risk of Stroke Hospitalization After Infertility Treatment

Maternal hereditary hemolytic anemia and birth defects in the National Birth Defects Prevention Study

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