A comprehensive study of pre-eclampsia in IVF and natural conceptions: clinical phenotypes, perinatal outcomes and neonatal echocardiography

Abstract

Research question: What differences exist in the preeclampsia phenotypes, perinatal outcomes, and neonatal echocardiography between pregnancies conceived naturally and through in vitro fertilization? DesignFrom January 2002 to December 2022, a total of 610 women diagnosed with preeclampsia were included. This research was conducted within the IVF and Maternal-Fetal Medicine Department of Kaohsiung Chang Gung Memorial Hospital. Participants were divided into two groups, one achieved pregnancy through IVF and another, spontaneously. This study reviewed preeclampsia phenotypes, perinatal outcomes, and screening of newborn echocardiography. Results: After conducting propensity score matching, the natural conception group had a higher prevalence of early-onset preeclampsia (53.9% vs. 37.7%, p = 0.04) and exhibited more severe features (89.1% vs. 69.8%, p = 0.01), when compared to the IVF group. Regarding perinatal outcomes, neonates in the IVF group had higher placental weights than those in the natural conception group (580 vs. 480 g, p = 0.031). There were no differences in the prevalence of abnormal newborn echocardiography. Multivariate analysis showed that greater gestational age at delivery reduced the likelihood of abnormal cardiac echo (RR 0.950, p=0.001), while pregestational diabetes increased it (RR 1.451, p=0.044). Septal defects were the most common, occurring in 15.5% of infants. Conclusion: Our study revealed that the impact of IVF conception on the preeclampsia severity is not as expected. Through neonatal echocardiography, a higher occurrence of abnormalities was observed compared to the general population. Furthermore, these issues were not linked to conception method, suggesting undisclosed factors that could influence the clinical features and perinatal outcomes of preeclampsia.