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Risk of ischemic placental disease is increased following in vitro fertilization with oocyte donation: a retrospective cohort study

  • Assisted Reproduction Technologies
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Abstract

Purpose

Assess the risk of ischemic placental disease (IPD) among in vitro fertilization (IVF; donor and autologous) pregnancies compared with non-IVF pregnancies.

Methods

This was a retrospective cohort study of deliveries from 2000 to 2015 at a tertiary hospital. The exposures, donor, and autologous IVF, were compared with non-IVF pregnancies and donor IVF pregnancies were also compared with autologous IVF pregnancies. The outcome was IPD (preeclampsia, placental abruption, small for gestational age (SGA), or intrauterine fetal demise due to placental insufficiency). We defined SGA as birthweight < 10th percentiles for gestational age and sex. A secondary analysis restricted SGA to < 3rd percentile.

Results

Of 69,084 deliveries in this cohort, 262 resulted from donor IVF and 3,501 from autologous IVF. Compared with non-IVF pregnancies, IPD was more common among donor IVF pregnancies (risk ratio (RR) = 2.9; 95% CI 2.5–3.4) and autologous IVF pregnancies (RR = 2.0; 95% CI 1.9–2.1), adjusted for age and parity. IVF pregnancies were more likely to be complicated by preeclampsia (donor RR = 3.8; 95% CI 2.8–5.0 and autologous RR = 2.2; 95% CI 2.0–2.5, adjusted for age, parity, and marital status), placental abruption (donor RR = 3.8; 95% CI 2.1–6.7 and autologous RR = 2.5; 95% CI 2.1–3.1, adjusted for age), and SGA (donor RR = 2.7; 95% CI 2.1–3.4 and autologous RR = 2.0; 95% CI 1.9–2.2, adjusted for age and parity). Results were similar when restricting SGA to < 3rd percentile.

Conclusion

Pregnancies conceived using donor IVF and autologous IVF were at higher risk of IPD and its associated conditions than non-IVF pregnancies and associations were consistently stronger for donor IVF pregnancies.

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Acknowledgments

We would like to acknowledge Laura Dodge and JoAnn Jordan for their assistance with obtaining data for this study. We would also like to acknowledge Stacey Missmer and Olga Basso for their review of this study.

Study funding

AMM was supported by NIH T32 HD052458—Boston University Reproductive, Perinatal and Pediatric Epidemiology Training Program.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center/Harvard Medical School, 330 Brookline Avenue, KS 3, Boston, MA, USA

    Anna M. Modest, Katherine M. Johnson, Brett C. Young & Michele R. Hacker

  2. Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA

    Anna M. Modest, Matthew P. Fox & Lauren A. Wise

  3. Center for Vascular Biology Research, Beth Israel Deaconess Medical Center/Harvard Medical School, 99 Brookline Avenue, RN 359, Boston, MA, 02215, USA

    S. Ananth Karumanchi

  4. Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA, 90048, USA

    S. Ananth Karumanchi

  5. Boston IVF, 130 2nd Avenue, Waltham, MA, 02451, USA

    Nina Resetkova

  6. Department of Global Health, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA

    Matthew P. Fox

  7. Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA

    Michele R. Hacker

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  1. Anna M. Modest
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Correspondence to Anna M. Modest.

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Modest, A.M., Johnson, K.M., Karumanchi, S.A. et al. Risk of ischemic placental disease is increased following in vitro fertilization with oocyte donation: a retrospective cohort study. J Assist Reprod Genet 36, 1917–1926 (2019). https://doi.org/10.1007/s10815-019-01545-3

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  • DOI: https://doi.org/10.1007/s10815-019-01545-3

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