| Background and objectiveIn recent years,as the incidence of infertility has increased year by year,my country’s assisted reproductive technology has also developed rapidly and has moved to the forefront of the world.While assisted reproductive technology in all regions of the country has helped more and more infertile couples solve their fertility problems,its safety has also attracted more attention.Assisted reproductive technology is safe on the whole,but in the process of wide application,the number of patients with complications during pregnancy is also increasing year by year.There have been a large number of reports on the impact of assisted reproductive technology on the perinatal complications of mothers and children at home and abroad,and there is no uniformity in the research on the correlation between assisted reproductive technology and hypertension in pregnancy.Hypertension in pregnancy is a common disease in obstetrics,causing damage to the heart,liver,brain,kidney and other important organs of pregnant women.It is the main cause of perinatal maternal and infant death.The most critical indicator for the diagnosis of hypertensive disorders of pregnancy is the increase in blood pressure.However,there are few studies on the effect of assisted reproduction on the blood pressure level of patients.In this study,we explored whether there were differences in hypertensive disorders of pregnancy and blood pressure levels during pregnancy between IVF-ET and natural conception to provide evidence for the safety of assisted reproductive technology.Materials and methodsSelected from January 1,2018 to December 31,2018 in the Northwestern Women’s and Children’s Hospital to give birth and received In vitro fertilization-embryo transfer for singleton mothers with 930 subjects as the exposure group.According to the age of ± 1year,In the hospitalized ward,with or without complications before pregnancy(Hepatitis B virus carriers,uterine fibroids,etc.),930 naturally conceived women who gave birth in our hospital during the same period were randomly matched 1:1 as the control group.In addition,we collected all twins pregnant women who met the criteria for inclusion and exclusion during the same period,including 493 twins with assisted reproduction and 329 twins with natural conception.General data of pregnant women are collected through our hospital case system: age,hospitalized area,pre-pregnancy comorbidities,body mass index before pregnancy,weight gain during pregnancy,education background,last admission blood pressure before delivery,highest blood pressure during pregnancy,postpartum discharge blood pressure,etc;laboratory indicators: Blood routine,urine routine,liver and kidney function,etc.All the above data are analyzed by empowerstats and R software.Results1.Pregnant women in the IVF-ET group were mostly elderly,first pregnancy,first delivery,higher body mass index before pregnancy,fewer previous miscarriages,and less weight gain during pregnancy.2.In singleton pregnancies,the IVF-ET group is more likely to develop new-onset hypertension during pregnancy.Multivariate logistic regression analysis,controlled for the influence of pregnancy times,parity,number of miscarriages,weight gain during pregnancy,pre-pregnancy BMI,education level and other factors.The risk of preeclampsia in the IVF-ET singleton group is 2.65 that of the natural conception group Times(OR: 2.65,[95%CI: 1.37,5.15]).3.In twin pregnancies,the incidence of gestational hypertension in the IVF-ET group was4.67%(23/493)higher than that in the natural conception group by 1.22%(4/329).Multivariate logistic regression analysis was used to adjust for age,pregnancy times,parity,BMI before pregnancy,after ethnic factors.There was no significant difference in the incidence of gestational hypertension between the IVF-ET group and the natural conception group(P=0.058).4.In singleton pregnancies,the incidence of new-onset hypertension during pregnancy in the IVF-ET singleton group of ages <30 and 30-35 years of age was higher than that of the natural conception group.The incidence of preeclampsia in the IVF-ET singleton group was higher than that of the naturally conceived singleton group in all age groups,and the difference between the two groups was statistically significant.5.In singleton pregnancies,the admission blood pressure,the highest blood pressure during pregnancy,and postpartum discharge blood pressure in the IVF-ET group were all higher than those in the natural conception group.Multi-factor generalized linear model analysis,corrected for pregnancy times,parity,weight gain during pregnancy,pre-pregnancy BMI,after the level of education,ethnicity and more by factors,IVF-ET group admission systolic blood pressure,diastolic blood pressure on admission,the highest systolic blood pressure during pregnancy,the maximum diastolic blood pressure,diastolic blood pressure were discharged from the hospital and systolic blood pressure higher.6.In twin pregnancies,the admission blood pressure,the highest blood pressure during pregnancy,and the postpartum discharge blood pressure in the IVF-ET group were higher than those in the natural conception group.Multi-factor generalized linear model analysis,controlling age,pregnancy times,parity,pre-pregnancy BMI,ethnicity and other factors Later,only the highest systolic blood pressure during pregnancy in the IVF-ET group was higher than that in the natural conception group.7.In singleton pregnancies,the hemoglobin,hematocrit,alanine aminotransferase,and urine protein of the IVF-ET group were higher than the natural conception group,and albumin was lower than the natural conception group.In twin pregnancies,the hemoglobin,hematocrit and uric acid of the IVF-ET group were higher than those of the natural conception group.8.In singleton pregnancies,the incidence of preeclampsia in the frozen embryo transfer group was higher than that in the fresh embryo transfer group.In twin pregnancies,the incidence of gestational hypertension in the frozen embryo transfer group was higher than that in the fresh embryo transfer group.9.In singleton pregnancies,the admission diastolic blood pressure,the highest systolic blood pressure during pregnancy,the highest diastolic blood pressure and the postpartum discharge blood pressure of the frozen embryo transfer group were higher than those of the fresh embryo group.10.In twin pregnancies,the admission systolic blood pressure,admission diastolic blood pressure,and highest systolic blood pressure of pregnant women in the frozen embryo transfer group were higher than those in the fresh embryo group.11.In singleton pregnancies,the IVF-ET group had a higher cesarean section rate than the natural conception group,and the difference was statistically significant.In twin pregnancies,the cesarean section rate was high in the IVF-ET group and the natural conception group,and the difference was not statistically significant.Conclusions1.Assisted reproductive technology will increase the risk of singleton preeclampsia.2.Frozen embryo transfer is associated with an increased risk of preeclampsia in singleton pregnancies and gestational hypertension in twin pregnancies..The prevention and control of hypertension in pregnancy is the key,especially the blood pressure control and treatment of patients after admission.Improve the prognosis of mothers and babies and reduce the occurrence of adverse outcomes. |
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