A recent study has revealed that infertility treatments, particularly assisted reproductive technology (ART), may increase the risk of in-hospital complications and other adverse pregnancy outcomes. These findings suggest that ART, while helping many women conceive, carries risks that should be carefully considered.
The study compared pregnancies resulting from ART with those conceived naturally, highlighting that ART was independently linked to a 1.7-fold increase in the risk of arrhythmia and a 2.5-fold higher risk of acute kidney injury. These risks persisted even after adjusting for baseline factors such as age, pre-existing health conditions, and other pregnancy-related variables.
Lead investigator Pensée Wu, a senior lecturer and maternal fetal medicine specialist at Keele University, expressed surprise at these results. She emphasized that ART was associated with complications beyond just pre-existing health conditions or older maternal age, which are typically considered risk factors for pregnancy complications.
Published in the Journal of the American Heart Association on February 22, this study aimed to address knowledge gaps surrounding the risks of ART-related pregnancy complications. Wu and her team conducted a retrospective analysis using data from the US National Inpatient Sample database, examining deliveries from 2008 to 2016. The cohort included 7,236,075 deliveries, of which 106,248 were conceived through ART. The researchers adjusted for factors such as age, income, race, and comorbidities to assess the relationship between ART and pregnancy outcomes.
The study found that the percentage of deliveries from ART increased significantly over time, from 0.05% in 2008 to 0.51% in 2016. Women who conceived through ART were typically older (35 years on average, compared to 28 for those who conceived naturally), more likely to be White, and from higher-income households.
In terms of outcomes, ART-conceived pregnancies were associated with a range of adverse events. These included a higher risk of acute kidney injury (2.5 times greater), arrhythmia (1.7 times greater), placental abruption, cesarean delivery, and preterm birth. Even women without cardiovascular risk factors or those not carrying multiple fetuses showed similar trends. Additionally, hospital costs for ART pregnancies were notably higher, with ART-related deliveries costing an average of $18,705 compared to $11,983 for natural pregnancies.
Wu stressed the importance of counseling patients, particularly those with existing cardiovascular risk factors, about the long-term cardiovascular risks of ART. She also emphasized that women should be made aware of the increased likelihood of pregnancy complications and the need for careful monitoring, especially during delivery. Health professionals should work closely with patients to mitigate these risks and ensure proper care throughout the pregnancy.
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