title: Increased incidence of gestational hypertension and preeclampsia after assisted reproductive technology treatment.
abstract: OBJECTIVE
  To determine the association between assisted reproductive technology (ART) treatment and the rate of combined gestational hypertension (GH), preeclampsia (PE).
  
  
  METHODS
  Retrospective population study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  A total of 596,520 mothers (3.6% ART mothers) who gave birth between 2007 and 2011.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Comparison of the rate of GH/PE for ART and non-ART mothers, with odds ratio (OR), adjusted odds ratio (AOR), and 95% confidence interval (CI) used to assess the association between ART and GH/PE.
  
  
  RESULTS
  The overall rate of GH/PE was 4.3%, with 6.4% for ART mothers and 4.3% for non-ART mothers. The rate of GH/PE was higher for mothers of twins than singletons (12.4% vs. 5.7% for ART mothers; 8.6% vs. 4.2% for non-ART mothers). The ART mothers had a 17% increased odds of GH/PE compared with the non-ART mothers (AOR 1.17; 95% CI, 1.10-1.24). After stratification by plurality, the difference in GH/PE rates between ART and non-ART mothers was not statistically significant, with AOR 1.05 (95% CI, 0.98-1.12) for mothers of singletons and AOR 1.10 (95% CI, 0.94-1.30) for mothers of twins.
  
  
  CONCLUSIONS
  The changes in AOR after stratification indicated that multiple pregnancies after ART are the single most likely explanation for the increased rate of GH/PE among ART mothers. The lower rate of GH/PE among mothers of singletons compared with mothers of twins suggests that a policy to minimize multiple pregnancies after ART may reduce the excess risk of GH/PE due to ART treatment.
authors.affiliation: Faculty of Health, University of Technology Sydney, Ultimo, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia. Electronic address: alex.wang@uts.edu.au.
authors.forename: Yueping A
authors.initials: YA
authors.lastname: Wang
authors.affiliation: School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Abrar A
authors.initials: AA
authors.lastname: Chughtai
authors.affiliation: Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Farquhar
authors.affiliation: Mercy Hospital for Women, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Pollock
authors.affiliation: School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Kei
authors.initials: K
authors.lastname: Lui
authors.affiliation: Faculty of Health, University of Technology Sydney, Ultimo, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D011159:Population Surveillance / Q000379:methods; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011272:Pregnancy, Multiple; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Assisted reproductive technology; gestational hypertension; preeclampsia