title: Fertility Treatments in Women Who Become Pregnant and Carried to Viability, and the Risk for Long-Term Maternal Cardiovascular Morbidity.
abstract: ObjectiveThe objective of this study was to investigate whether patients who undergo fertility treatments (ovulation induction or in vitro fertilization) have an increased risk for future maternal cardiovascular morbidity.DesignA population-based study compared the incidence of long-term cardiovascular morbidity in a cohort of women with and without a previous exposure to fertility treatments. Deliveries occurred during a 25-year period, with a mean follow-up of 11.7 years. Women with known cardiovascular disease and congenital cardiovascular malformations diagnosed before the index pregnancy and multiple pregnancies were excluded.ResultsDuring the study period, 99,291 patients met the inclusion criteria; 4.1% (n= 4,153) occurred in patients with exposure to fertility treatments. Patients with exposure to fertility treatments did not have higher rates of cardiovascular morbidity. Using a Kaplan-Meier survival curve, patients with an exposure to fertility treatments had no higher cumulative incidence of cardiovascular hospitalizations. Using a Cox proportional hazards model, adjusted for confounders such as preeclampsia, diabetes mellitus, and obesity, exposure to fertility treatments remained unassociated with cardiovascular hospitalizations (adjusted hazard ratio = 1.1; 95% confidence interval, 0.9-1.3;p= 0.441).ConclusionIn our population, during a mean follow-up period of 11.7, results showed no increased risk for cardiovascular morbidity in women undergoing fertility treatments.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: R Djaoui
authors.initials: RD
authors.lastname: Ben-Yaakov
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Kessous
authors.affiliation: Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Shoham-Vardi
authors.affiliation: Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Sergienko
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Pariente
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016208:Databases, Factual; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D009765:Obesity / Q000453:epidemiology*; D010062:Ovulation Induction / Q000009:adverse effects; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult