Pensée Wu, MD, Senior Lecturer, Honorary Consultant Obstetrician and Subspecialist in Maternal Fetal Medicine Keele University. In this video, she speaks about In‐Hospital Complications in Pregnancies Conceived by Assisted Reproductive Technology. 

Outline

Origins:

Infertility affects around 48 million couples worldwide, and assisted reproductive technology (ART) has emerged as a popular treatment option. Concerns about ART-related pregnancy complications have escalated as mother age has increased, as have prepregnancy cardiovascular risk factors like chronic hypertension, obesity, and diabetes. In-hospital complications associated with ART pregnancies, on the other hand, are poorly reported.

Methodology and Outcomes:

We examined hospital deliveries conceived with or without ART from the United States National Inpatient Sample database between January 1, 2008, and December 31, 2016, to identify patient characteristics, obstetric outcomes, vascular complications, and temporal trends of ART-conceived pregnancies. In our study, we included 106 248 ART-conceived pregnancies and 34 167 246 non-ART-conceived pregnancies. Women who used assisted reproductive technology (ART) were older (35 vs. 28 years; P0.0001) and had more comorbidities. Acute kidney injury: adjusted odds ratio [aOR], 2.52; 95 percent confidence interval [CI], 1.99–3.19; and arrhythmia: aOR, 1.65; 95 percent CI, 1.46–1.86) and adverse obstetric outcomes (placental abruption: aOR, 1.57; 95 percent CI, 1.41–1.74; cesarean delivery: aOR, 1.38; 95 percent CI, 1.38–1.86) were associated with ART-conceived Hospital expenditures were greater in women who did not use ART ($18 705 versus $11 983; P0.0001).

Observations:

ART-conceived pregnancies have a higher risk of poor obstetric outcomes and vascular issues when compared to spontaneous conception. Clinicians should have in-depth discussions regarding the effects of ART in women during prenatal counseling.