title: Oocyte donation pregnancies and the risk of preeclampsia or gestational hypertension: a systematic review and metaanalysis.
abstract: The purpose of this study was to determine whether pregnancies that were achieved via oocyte donation, compared with pregnancies achieved via other assisted reproductive technology methods or natural conception, demonstrate increased risk of preeclampsia or gestational hypertension. Comparative studies of pregnancies that were achieved with oocyte donation vs other methods of assisted reproductive technology or natural conception with preeclampsia or gestational hypertension were included as 1 of the measured outcomes. Abstracts and unpublished studies were excluded. Two reviewers independently selected studies, which were assessed for quality with the use of methodological index for non-randomized studies, and extracted the data. Statistical analysis was conducted. Of the 523 studies that were reviewed initially, 19 comparative studies met the predefined inclusion and exclusion criteria and were included in the metaanalysis, which allowed for analysis of a total of 86,515 pregnancies. Our pooled data demonstrated that the risk of preeclampsia is higher in oocyte-donation pregnancies compared with other methods of assisted reproductive technology (odds ratio, 2.54; 95% confidence interval, 1.98-3.24; P < .0001) or natural conception (odds ratio, 4.34; 95% confidence interval, 3.10-6.06; P < .0001). The risk of gestational hypertension was also increased significantly in oocyte donation pregnancies in comparison with other methods of assisted reproductive technology (odds ratio, 3.00; 95% confidence interval, 2.44-3.70; P < .0001) or natural conception (odds ratio, 7.94; 95% confidence interval, 1.73-36.36; P = .008). Subgroup analysis that was conducted for singleton and multiple gestations demonstrated a similar risk for preeclampsia and gestational hypertension in both singleton and multiple gestations. This metaanalysis provides further evidence that supports that egg donation increases the risk of preeclampsia and gestational hypertension compared with other assisted reproductive technology methods or natural conception.
authors.affiliation: Department of Pediatric Pathology, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Pourya
authors.initials: P
authors.lastname: Masoudian
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Nasr
authors.affiliation: Department of Pediatric Pathology, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Joseph
authors.initials: J
authors.lastname: de Nanassy
authors.affiliation: Department of Obstetrics and Gynecology, The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Fung-Kee-Fung
authors.affiliation: Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Shannon A
authors.initials: SA
authors.lastname: Bainbridge
authors.affiliation: Department of Pediatric Pathology, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: deldemellawy@cheo.on.ca.
authors.forename: Dina
authors.initials: D
authors.lastname: El Demellawy
mesh_terms: D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology*; D016017:Odds Ratio; D018587:Oocyte Donation / Q000009:adverse effects*; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors
keywords: gestational hypertension; oocyte donation; preeclampsia