In‐Hospital Complications in Pregnancies Conceived by Assisted Reproductive Technology

Abstract

Background Assisted reproductive technology (ART) has emerged as a common treatment option for infertility, a problem that affects an estimated 48 million couples worldwide. Advancing maternal age with increasing prepregnancy cardiovascular risk factors, such as chronic hypertension, obesity, and diabetes, has raised concerns about pregnancy complications associated with ART. However, in‐hospital complications following pregnancies conceived by ART are poorly described. Methods and Results To assess the patient characteristics, obstetric outcomes, vascular complications and temporal trends of pregnancies conceived by ART, we analyzed hospital deliveries conceived with or without ART between January 1, 2008, and December 31, 2016, from the United States National Inpatient Sample database. We included 106 248 deliveries conceived with ART and 34 167 246 deliveries conceived without ART. Women who conceived with ART were older (35 versus 28 years; P <0.0001) and had more comorbidities. ART‐conceived pregnancies were independently associated with vascular complications (acute kidney injury: adjusted odds ratio [aOR], 2.52; 95% CI 1.99–3.19; and arrhythmia: aOR, 1.65; 95% CI, 1.46–1.86), and adverse obstetric outcomes (placental abruption: aOR, 1.57; 95% CI, 1.41–1.74; cesarean delivery: aOR, 1.38; 95% CI, 1.33–1.43; and preterm birth: aOR, 1.26; 95% CI, 1.20–1.32), including in subgroups without cardiovascular disease risk factors or without multifetal pregnancies. Higher hospital charges ($18 705 versus $11 983; P <0.0001) were incurred compared with women who conceived without ART. Conclusions Pregnancies conceived by ART have higher risks of adverse obstetric outcomes and vascular complications compared with spontaneous conception. Clinicians should have detailed discussions on the associated complications of ART in women during prepregnancy counseling.

Anesthetic Management of Cesarean Section in the Case of a Sextuplet Pregnancy and Polycystic Ovarian Syndrome

“…This includes multifetal gestations, prematurity, cesarean delivery, placenta previa, abruptio placentae, preeclampsia, and gestational diabetes mellitus [ 11 ]. Subfertile females tend to have more pre-existing medical conditions, which increase the risk of maternal morbidity [ 4 , 12 ]. Obstetric hemorrhages have been reported to be increased after assisted reproduction technologies, but the mechanisms involved are unclear [ 13 ].…”

Infantile Prognosis of Neonates Conceived by Assisted Reproductive Technology: A Prospective Study

“…Wu et al reported that the risk of adverse obstetric outcomes and vascular complications was higher in pregnancies conceived by ART compared to natural conception (17). Previous studies have suggested an increased risk of preterm delivery and IUGR in children conceived by ART (18)(19)(20)(21).…”

Timing of induction of labour in the prevention of prolonged pregnancy: Systematic review with meta‐analysis

“…Often these characteristics interact (older women are more likely to use ART, and have higher BMI), and therefore data may have significant confounding, highlighting the need to use randomised trials, ideally with stratification. Additionally, older women or those using fertility treatments are often excluded from trials as they are more likely to have complicated or multifetal pregnancies 47–49 …”

“…Additionally, older women or those using fertility treatments are often excluded from trials as they are more likely to have complicated or multifetal pregnancies. [47][48][49]…”