Risk of preeclampsia following assisted reproductive technology: systematic review and meta-analysis of 72 cohort studies

Abstract

Objective: Previous studies have indicated that women with assisted reproductive technology (ART) pregnancy have an increased risk of preeclampsia. The aim of this current study was to estimate, through a systematic review and meta-analysis of cohort studies, the risk of preeclampsia in women who conceived with ART.

Materials and methods: We searched ISI Web of Knowledge, Medline/PubMed, Scopus and Embase up to August 2017 for English-language articles pertaining to risk of preeclampsia in ART pregnancy using standard keywords. Data extraction was conducted by two authors and quality of the studies was assessed using the Newcastle–Ottawa Scale. A random-effects model was used for the meta-analysis.

Results: In total, 72 cohort studies (n = 164 870) were included. The results of Cochran test and I² statistic indicated considerable heterogeneity among studies (Q = 15 415.61, df = 71, p < .001, I²=99.5%). The pooled estimate of preeclampsia risk using the random effects model was 10.8% (95% CI: 9.10–12.5). Furthermore, the funnel plot and Begg’s test showed evidence of publication bias.

Conclusions: We found that the risk of preeclampsia was very high among women who conceived with ART. Women should be counseled carefully before undergoing ART treatment.

Keyword:

• Assisted reproductive technology
• infertility
• meta-analysis
• preeclampsia
• systematic review

Acknowledgments

Esmaeil Khedmati Morasae is part-funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, North West Coast (NIHR CLAHRC NWC). The views expressed are those of the author and not necessary those of the NHS, NIHR or Department of Health.

Disclosure statement

The authors declare that they have no conflict of interest.

Box 1. Search strategy for MEDLINE (MeSH, Medical Subject Headings).