Hélène Letur1, Maëliss Peigné2, Jeanine Ohl3, Isabelle Cédrin-Durnerin4, Emmanuelle Mathieu-D'Argent5, Florence Scheffler6, Veronika Grzegorczyk-Martin7, Jacques de Mouzon8. 1. Centre de Fertilité, Institut Mutualiste Montsouris, Paris, France. Electronic address: helene.letur@imm.fr. 2. Service de Médecine de la Reproduction, Hôpital Jeanne de Flandre, Centre Hospitalier Régional et Universitaire, Lille, France. 3. Service de Gynécologie-Obstétrique, Centre Médico-Chirurgical et Obstétrical, Centre Hospitalier Universitaire, Schiltigheim, France. 4. Service de Médecine de la Reproduction, Assistance Publique des Hôpitaux de Paris, Hôpital Jean-Verdier, Bondy, France. 5. Service de Gynécologie Obstétrique, Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Paris, France. 6. Médecine et Biologie de la Reproduction, Cytogénétique et Centre d'Etude et de Conservation des Oeufs et du Sperme de Picardie, Centre Hospitalier Universitaire d'Amiens Sud, Amiens, France. 7. Service de Gynécologie-Obstétrique, Centre Hospitalier Intercommunal des 4 Villes, Site Sèvres, Sèvres, France. 8. Institut National de la Santé et de la Recherche Médicale, Service de Gynécologie-Obstétrique II et Médecine de la Reproduction, APHP, Cochin Port Royal, Paris, France.
Abstract
OBJECTIVE: To determine whether egg donation (ED) pregnancies are at higher risk of pregnancy-induced hypertension (PIH) than those achieved by autologous assisted reproductive technology (ART; controls). DESIGN: Anonymous comparative observational matched cohort study. SETTING: Assisted reproductive technology centers. PATIENT(S): Two hundred seventeen ED and 363 control singleton pregnancies matched at 7-8 weeks (pregnancy date, parity, cycle type [fresh/frozen] and women's age). According to French practice, all women were under 45. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Percentage of PIH for ED versus controls. RESULT(S): The groups were comparable (mean age, 34.5). PIH was more frequent during ED pregnancies (17.8% vs. 5.3%), as was preeclampsia (11.2% vs. 2.8%) and eclampsia (1.8% vs. 0.0%). In multivariate analyses, PIH risk increased with ED (odds ratio [OR], 3.92; 95% confidence interval [CI], 1.93-7.97) and women's age (OR, 1.08; 95% CI, 1.00-1.16). No significant effect of previous pregnancies or cycle rank/type was observed. CONCLUSION(S): This study had sufficient power to detect doubling of the PIH rate. It was demonstrated that the risk of PIH was tripled for ED versus controls. Even in young women, ED is a risk factor for PIH. An immunological explanation seems most likely, that is, the fetus is fully allogeneic to its mother. This risk must be acknowledged to inform couples and provide careful pregnancy monitoring.
OBJECTIVE: To determine whether egg donation (ED) pregnancies are at higher risk of pregnancy-induced hypertension (PIH) than those achieved by autologous assisted reproductive technology (ART; controls). DESIGN: Anonymous comparative observational matched cohort study. SETTING: Assisted reproductive technology centers. PATIENT(S): Two hundred seventeen ED and 363 control singleton pregnancies matched at 7-8 weeks (pregnancy date, parity, cycle type [fresh/frozen] and women's age). According to French practice, all women were under 45. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Percentage of PIH for ED versus controls. RESULT(S): The groups were comparable (mean age, 34.5). PIH was more frequent during ED pregnancies (17.8% vs. 5.3%), as was preeclampsia (11.2% vs. 2.8%) and eclampsia (1.8% vs. 0.0%). In multivariate analyses, PIH risk increased with ED (odds ratio [OR], 3.92; 95% confidence interval [CI], 1.93-7.97) and women's age (OR, 1.08; 95% CI, 1.00-1.16). No significant effect of previous pregnancies or cycle rank/type was observed. CONCLUSION(S): This study had sufficient power to detect doubling of the PIH rate. It was demonstrated that the risk of PIH was tripled for ED versus controls. Even in young women, ED is a risk factor for PIH. An immunological explanation seems most likely, that is, the fetus is fully allogeneic to its mother. This risk must be acknowledged to inform couples and provide careful pregnancy monitoring.
Authors: V E Klenov; S L Boulet; R B Mejia; D M Kissin; E Munch; A Mancuso; B J Van Voorhis Journal: J Assist Reprod Genet Date: 2018-06-21 Impact factor: 3.412
Authors: Xuezi Tian; Kaveri T S Aiyer; Johanna M Kapsenberg; Dave L Roelen; Marie-Louise van der Hoorn; Michael Eikmans Journal: Am J Reprod Immunol Date: 2021-12-04 Impact factor: 3.777