title: Gestational hypertension in pregnancies supported by infertility treatments: role of infertility, treatments, and multiple gestations.
abstract: OBJECTIVE
  To investigate the association between infertility treatments and gestational hypertension and preeclampsia.
  
  
  METHODS
  Retrospective observational cohort.
  
  
  METHODS
  General population, United States and Canada.
  
  
  METHODS
  Five thousand one hundred fifty-one women with non-malformed infants participating in the Slone Epidemiology Center Birth Defects Study between 1998 and 2006.
  
  
  METHODS
  Women were interviewed within 6 months after delivery about sociodemographic and medical factors, about the onset of gestational hypertension and preeclampsia, and about infertility treatments.
  
  
  METHODS
  We estimated relative risks and 95% confidence intervals by using unconditional logistic regression.
  
  
  RESULTS
  The incidence of gestational hypertension was 8.9% (423/4,762) among women without infertility treatments and was 15.8% (55/349) among women undergoing infertility treatments. Compared with spontaneous pregnancies, the crude relative risk for gestational hypertension in pregnancies resulting from infertility treatments was 1.9 (95% confidence interval, 1.4-2.6). Multivariate adjustment for parity and prepregnancy body mass index resulted in a relative risk of 1.6 (1.1-2.1). Further adjustment for multiple pregnancies, or restriction of the analyses to singleton pregnancies, moved the relative risk to 1.3. Each specific infertility procedure or drug was associated with a similarly elevated risk, which disappeared after adjustment for multiple gestations. Results were similar for preeclampsia.
  
  
  CONCLUSIONS
  Pregnancies resulting from infertility treatments have a higher incidence of gestational hypertension and preeclampsia than do spontaneous conceptions. This increased risk is largely explained by the higher frequency of multiple gestations.
authors: Slone Epidemiology Center at Boston University, Boston, Massachusetts 02215, USA.
authors: Sonia
authors: S
authors: Hernández-Díaz
authors: Martha M
authors: MM
authors: Werler
authors: Allen A
authors: AA
authors: Mitchell
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005299:Fertility Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D007231:Infant, Newborn; D007246:Infertility / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000502:physiology* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D005299:Fertility Agents