Risk of Hypertensive Disorders in Pregnancy After Fresh and Frozen Embryo Transfer in Assisted Reproduction A Population-Based Cohort Study With Within-Sibship Analysis
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Risk of Hypertensive Disorders in Pregnancy After Fresh and Frozen Embryo Transfer in Assisted Reproduction A Population-Based Cohort Study With Within-Sibship Analysis. / Petersen, Sindre H.; Westvik-Johari, Kjersti; Spangmose, Anne Laerke; Pinborg, Anja; Romundstad, Liv Bente; Bergh, Christina; Asvold, Bjorn Olav; Gissler, Mika; Tiitinen, Aila; Wennerholm, Ulla Britt; Opdahl, Signe.
In: Hypertension, Vol. 80, No. 2, 2023, p. E6-E16.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Risk of Hypertensive Disorders in Pregnancy After Fresh and Frozen Embryo Transfer in Assisted Reproduction A Population-Based Cohort Study With Within-Sibship Analysis
AU - Petersen, Sindre H.
AU - Westvik-Johari, Kjersti
AU - Spangmose, Anne Laerke
AU - Pinborg, Anja
AU - Romundstad, Liv Bente
AU - Bergh, Christina
AU - Asvold, Bjorn Olav
AU - Gissler, Mika
AU - Tiitinen, Aila
AU - Wennerholm, Ulla Britt
AU - Opdahl, Signe
N1 - Publisher Copyright: © 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Background Frozen embryo transfer (frozen-ET) is increasingly common because of improved cryopreservation methods and elective freezing of all embryos. Frozen-ET is associated with higher risk of hypertensive disorders in pregnancy than both natural conception and fresh embryo transfer (fresh-ET), but whether this is attributable to parental factors or treatment is unknown. Methods Using the Medical Birth Registries of Denmark (1994-2014), Norway, and Sweden (1988-2015), linked to data from national quality registries and databases on assisted reproduction, we designed a population-based cohort study with within-sibship comparison. We included 4 426 691 naturally conceived, 78 300 fresh-ET, and 18 037 frozen-ET singleton pregnancies, of which 33 209 sibships were conceived using different conception methods. Adjusted odds ratios (aOR) of hypertensive disorders in pregnancy for fresh-ET and frozen-ET versus natural conception with 95% CI were estimated using multilevel logistic regression, where random effects provided conventional population-level estimates and fixed effects gave within-sibship estimates. Main models included adjustment for birth year, maternal age, parity, and country. Results Risk of hypertensive disorders in pregnancy was higher after frozen-ET compared to natural conception, both at population-level (7.4% versus 4.3%, aOR, 1.74 [95% CI, 1.61-1.89]) and within sibships (aOR, 2.02 [95% CI, 1.72-2.39]). For fresh-ET, risk was similar to natural conception, both at population-level (aOR, 1.02 [95% CI, 0.98-1.07]) and within sibships (aOR, 0.99 [95% CI, 0.89-1.09]). Conclusions Frozen-ET was associated with substantially higher risk of hypertensive disorders in pregnancy, even after accounting for shared parental factors within sibships.
AB - Background Frozen embryo transfer (frozen-ET) is increasingly common because of improved cryopreservation methods and elective freezing of all embryos. Frozen-ET is associated with higher risk of hypertensive disorders in pregnancy than both natural conception and fresh embryo transfer (fresh-ET), but whether this is attributable to parental factors or treatment is unknown. Methods Using the Medical Birth Registries of Denmark (1994-2014), Norway, and Sweden (1988-2015), linked to data from national quality registries and databases on assisted reproduction, we designed a population-based cohort study with within-sibship comparison. We included 4 426 691 naturally conceived, 78 300 fresh-ET, and 18 037 frozen-ET singleton pregnancies, of which 33 209 sibships were conceived using different conception methods. Adjusted odds ratios (aOR) of hypertensive disorders in pregnancy for fresh-ET and frozen-ET versus natural conception with 95% CI were estimated using multilevel logistic regression, where random effects provided conventional population-level estimates and fixed effects gave within-sibship estimates. Main models included adjustment for birth year, maternal age, parity, and country. Results Risk of hypertensive disorders in pregnancy was higher after frozen-ET compared to natural conception, both at population-level (7.4% versus 4.3%, aOR, 1.74 [95% CI, 1.61-1.89]) and within sibships (aOR, 2.02 [95% CI, 1.72-2.39]). For fresh-ET, risk was similar to natural conception, both at population-level (aOR, 1.02 [95% CI, 0.98-1.07]) and within sibships (aOR, 0.99 [95% CI, 0.89-1.09]). Conclusions Frozen-ET was associated with substantially higher risk of hypertensive disorders in pregnancy, even after accounting for shared parental factors within sibships.
KW - cryopreservation
KW - embryo transfer
KW - fertilization in vitro
KW - hypertension
KW - pre-eclampsia
KW - pregnancy
KW - siblings
UR - http://www.scopus.com/inward/record.url?scp=85146532062&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.122.19689
DO - 10.1161/HYPERTENSIONAHA.122.19689
M3 - Journal article
C2 - 36154568
AN - SCOPUS:85146532062
VL - 80
SP - E6-E16
JO - Hypertension
JF - Hypertension
SN - 0194-911X
IS - 2
ER -
ID: 367006460