Pregnancy following IVF might double risk of pre-eclampsia

Gestational surrogates and women undergoing fertility treatments may have an increased risk of developing pre-eclampsia.

New research looking at the association between cardiovascular complications and fertility treatment was presented at the 2023 World Congress of Cardiology: Together With the World Congress of Cardiology and has not yet been peer-reviewed.

'Dedicated cardiovascular care needs to be incorporated into the routine follow-up of patients conceiving through assisted reproductive technologies,' said lead author Dr Ahmad Mustafa, a cardiologist from Staten Island University, New York.

The team analysed 2.2 million health records of pregnant women, of which 5874 pregnancies were a result of fertility treatment and of those 190 involved gestational surrogates. Pregnancy health records for women who had undergone fertility treatment were pair-matched with women who had conceived naturally by age, race and baseline health conditions. Results showed that women who were pregnant following fertility treatment had around twice the risk of pre-eclampsia than women who had conceived naturally.

Researchers also compared healthcare records of gestational surrogates and other women who were pregnant following IVF and found a relatively lower risk of preeclampsia among gestational surrogates. The authors hypothesise that this could be due to gestational surrogates being younger and healthier.

Pre-eclampsia is categorised as a serious pregnancy complication that contributes to fetal and maternal morbidities. While often asymptomatic, complications such as seizures and or death can occur in some patients. It can be diagnosed via high levels of protein in the urine or high blood pressure and risks increase as pregnancy progresses.

While there have been previous studies that have observed various cardiovascular risks of fertility treatments, none were able to provide an assessment of the complications at a national level.

Even though it is not understood what mechanism could be underlying this finding, authors suggest that it may be due to the implantation of the egg at an alternate location in the uterus leading to a difference in the placental development.

While this study should not put anyone off surrogacy or fertility treatments, said Dr Mustafa, it could help pregnant individuals, those planning to undergo fertility treatment, and their healthcare professionals to understand the risks and improve opportunities for appropriate monitoring and taking preventative measures.

'Having twice the risk of pre-eclampsia compared to traditional pregnancy should not discourage people from considering assisted reproductive technologies. However, it is important to follow up with a cardio-obstetrician or maternal-fetal medicine specialist for appropriate care and timely management if cardiovascular issues arise,' Dr Mustafa said.