Higher gestational weight gain and lower serum estradiol levels are associated with increased risk of preeclampsia after in vitro fertilization.

Abstract

To assess the association of preeclampsia with serum estradiol (E2) and progesterone (P4) levels on the day of human chorionic gonadotropin (hCG) administration during controlled ovarian hyperstimulation (COH) for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). This was a hospital-based cohort study using clinical data from the Kaohsiung Chang Gung Memorial Hospital Obstetric and Neonatal Database (KCGMHOND) from Jan 1, 2001 to December 1, 2018. A total of 622 women who had live births after fresh IVF/ICSI-ET during the study period met our inclusion criteria. Twenty-eight women (4.5%) met the diagnostic criteria for preeclampsia. However, women in the preeclampsia group had a significantly higher body weight at delivery (80.5 vs. 70.0kg, p<0.001) and gestational weight gain (19.6 vs. 13.0kg, p=0.002) and had lower use of ICSI (10.7% vs. 29.9%, p=0.021). We performed logistic regression analysis of the relationship of patient and treatment characteristics with preeclampsia. The crude ORs indicated that young female age≤34, not using ICSI, E2 on hCG day<1200pg/mL and gestational weight gain>20kg were associated with preeclampsia. After adjustment for confounding, the only factors that remained significant were E2 on hCG day<1200pg/mL (aOR=4.634, 95% CI=1.061-20.222), and gestational weight gain>20kg (aOR: 13.601, 95% CI: 3.784, 48.880). For women receiving IVF/ICSI, lower estradiol hormone levels on the day of hCG administration and higher pregnancy weight gain are related with subsequent preeclampsia.