Oocyte donation pregnancies and the risk of preeclampsia or gestational hypertension: a systematic review and metaanalysis

Masoudian, Pourya; Nasr, Ahmed; Nanassy, Joseph de; Fung-Kee-Fung, Karen; Bainbridge, Shannon; Demellawy, Dina El

doi:10.1016/j.ajog.2015.11.020

Cited by 129 publications

(75 citation statements)

References 58 publications

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“…There is a much higher incidence of obstetric complications in multiple OD pregnancies compared to singleton OD pregnancies with regard to preeclampsia (24.8 versus 8 %), preterm delivery at ≦37 weeks (54.9 versus 10.2 %), and cesarean section (81.4 versus 64 %) [2]. The risks of preeclampsia and gestational hypertension in twin OD pregnancies were 2.56 (1.84-3.58) and 3.08 (1.95-4.87) compared to those in twin pregnancies after methods of ART [42]. Therefore, transfer of only a single embryo should be recommended to patients using OD.…”

Section: Introductionmentioning

confidence: 86%

“…Metaanalysis of data on 86,515 OD pregnancies has revealed a higher risk of preeclampsia (odds ratio 2.54 compared with ART, odds ratio 4.34 compared with natural conception) and gestational hypertension (odds ratio 3.00 compared with ART, odds ratio 7.94 compared with natural conception) [42]. Interestingly, the incidence of hypertensive disorders (including gestational hypertension and preeclampsia) is lower when the oocyte donor is related to the recipient [25].…”

Section: Introductionmentioning

confidence: 95%

“…OD pregnancy is associated with an elevated risk of gestational hypertension and preeclampsia [6,42,46,76]. Metaanalysis of data on 86,515 OD pregnancies has revealed a higher risk of preeclampsia (odds ratio 2.54 compared with ART, odds ratio 4.34 compared with natural conception) and gestational hypertension (odds ratio 3.00 compared with ART, odds ratio 7.94 compared with natural conception) [42].…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

A new era in reproductive medicine: consequences of third-party oocyte donation for maternal and fetal health

et al. 2016

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The fetus is a semi-allograft for the maternal host in natural pregnancy, but the fetus is a complete allograft after oocyte donation (OD), and there is greater antigenic dissimilarity with the mother. Thus, OD pregnancy is a good model for understanding how the fetus is protected by the maternal immune system. Recent clinical data have revealed a higher risk of miscarriage, gestational hypertension, preterm birth, and low birth weight with OD pregnancy. There is also a higher incidence of chorionic deciduitis, dense fibrinoid deposits in the chorionic basal plate, inflammatory lesions in the chorionic plate, and C4d deposition on syncytiotrophoblasts in OD pregnancy. Impaired accumulation of T cells, regulatory T (Treg) cells, natural killer (NK) cells, and monocytes in the decidua basalis and poor remodeling of spiral arteries are observed in OD pregnancy irrespective of whether preeclampsia occurs. These findings may partly explain why OD pregnancy is associated with a high risk of gestational hypertension and preeclampsia. We need to clarify the immunological and pathological differences between uncomplicated and complicated OD pregnancy. In uncomplicated OD pregnancy, the level of HLA match between mother and baby is significantly higher than would be expected by chance, suggesting that miscarriage may be frequent with marked HLA mismatch. This review discusses the relationship between various aspects of the immune system and complications of OD pregnancy.

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Section: Introductionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 98%

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A new era in reproductive medicine: consequences of third-party oocyte donation for maternal and fetal health

et al. 2016

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“…As a rule of thumb, the risk of PE increases along with the complexity of the manoeuvres needed for the assisted fertilization (in particular for in vitro procedures), and is probably the highest in heterologous egg donation [116][117][118].…”

Section: Pe Occurring In Patients Without Any Previous or Present Sigmentioning

confidence: 99%

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

Piccoli

Cabiddu

Castellino³

et al. 2017

J Nephrol

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Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndrome (haemolysis, increase in liver enzyme, low platelets) are included. Both nephrologists and obstetricians are involved in the management of the disease, according to different protocols, and the clinical management, as well as the role for each specialty, differs worldwide. The increased awareness of the role of chronic kidney disease in pregnancy, complicating up to 3% of pregnancies, and the knowledge that PE is associated with an increased risk for development of CKD later in life have recently increased the interest and redesigned the role of the nephrologists in this context. However, while the heterogeneous definitions of PE, its recent reclassification, an emerging role for biochemical biomarkers, the growing body of epidemiological data and the new potential therapeutic interventions lead to counsel long-term follow-up, the lack of resources for chronic patients and the increasing costs of care limit the potential for preventive actions, and suggest tailoring specific interventional strategies. The aim of the present position statement of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology is to review the literature and to try to identify theoretical and pragmatic bases for an agreed management of PE in the nephrological setting, with particular attention to the prevention of the syndrome (recurrent PE, presence of baseline CKD) and to the organization of the postpartum follow-up.

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“…Thus, it is not inconceivable that lack of timely or sufficient exposure to seminal plasma may predispose to preeclampsia [105]. We further postulate that the increased risk of preeclampsia in donor egg recipient [106] and frozen embryo transfer [107–109] pregnancies may in part stem from lack of fine tuning of decidualization by corpus luteal products like relaxin (and perhaps other, as of yet, undiscovered corpus luteal factors), which is missing, if embryo transfer occurs in the absence of a corpus luteum. Finally, with the revelation of intimate host-microbial interactions in the gut and other organs [110–112], the existence of an endometrial microbiome is a distinct possibility, which has recently gained support [113–115].…”

Section: Potential Mechanisms Of Impaired Decidualization In Preeclammentioning

confidence: 99%

Emerging role for dysregulated decidualization in the genesis of preeclampsia

2017

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In normal human placentation, uterine invasion by trophoblast cells and subsequent spiral artery remodeling depend on cooperation among fetal trophoblasts and maternal decidual, myometrial, immune and vascular cells in the uterine wall. Therefore, aberrant function of anyone or several of these cell-types could theoretically impair placentation leading to the development of preeclampsia. Because trophoblast invasion and spiral artery remodeling occur during the first half of pregnancy, the molecular pathology of fetal placental and maternal decidual tissues following delivery may not be informative about the genesis of impaired placentation, which transpired months earlier. Therefore, in this review, we focus on the emerging prospective evidence supporting the concept that deficient or defective endometrial maturation in the late secretory phase and during early pregnancy, i.e., pre-decidualization and decidualization, respectively, may contribute to the genesis of preeclampsia. The first prospectively-acquired data directly supporting this concept were unexpectedly revealed in transcriptomic analyses of chorionic villous samples (CVS) obtained during the first trimester of women who developed preeclampsia 5 months later. Additional supportive evidence arose from investigations of Natural Killer cells in first trimester decidua from elective terminations of women with high resistance uterine artery indices, a surrogate for deficient trophoblast invasion. Last, circulating insulin growth factor binding protein-1, which is secreted by decidual stromal cells was decreased during early pregnancy in women who developed preeclampsia. We conclude this review by making recommendations for further prospectively-designed studies to corroborate the concept of endometrial antecedents of preeclampsia. These studies could also enable identification of women at increased risk for developing preeclampsia, unveil the molecular mechanisms of deficient or defective (pre)decidualization, and lead to preventative strategies designed to improve (pre)decidualization, thereby reducing risk for preeclampsia development.

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Oocyte donation pregnancies and the risk of preeclampsia or gestational hypertension: a systematic review and metaanalysis

Cited by 129 publications

References 58 publications

A new era in reproductive medicine: consequences of third-party oocyte donation for maternal and fetal health

A new era in reproductive medicine: consequences of third-party oocyte donation for maternal and fetal health

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

Emerging role for dysregulated decidualization in the genesis of preeclampsia

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