Geburtshilfe Frauenheilkd 2018; 78(10): 178
DOI: 10.1055/s-0038-1671289
Poster
Freitag, 02.11.2018
Endokrinologie und Reproduktionsmedizin II
Georg Thieme Verlag KG Stuttgart · New York

Absence of the corpus luteum in early pregnancy increases the risk of preeclampsia – unvalued potential to improve maternal vascular health?

F von Versen-Höynck
1   Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Sunnyvale, Vereinigte Staaten von Amerika
2   Medizinische Hochschule Hannover, Frauenklinik, Hannover, Deutschland
,
KH Chiu
3   Department of Biostatistics, University of Florida, Gainesville, Vereinigte Staaten von Amerika
,
YY Chi
3   Department of Biostatistics, University of Florida, Gainesville, Vereinigte Staaten von Amerika
,
RR Fleischmann
1   Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Sunnyvale, Vereinigte Staaten von Amerika
,
W Zhang
1   Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Sunnyvale, Vereinigte Staaten von Amerika
,
VD Winn
4   Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive, Stem Cell and Perinatal Biology, Stanford, Vereinigte Staaten von Amerika
,
KP Conrad
5   Departments of Physiology and Functional Genomics and Obstetrics and Gynecology, D. H. Barron Reproductive and Perinatal Biology Research Program, University of Florida College of Medicine, Gainesville, Vereinigte Staaten von Amerika
,
VL Baker
1   Stanford University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Sunnyvale, Vereinigte Staaten von Amerika
› Author Affiliations
Further Information

Publication History

Publication Date:
20 September 2018 (online)

Also available at
 

Objective:

In-vitro fertilization (IVF) is associated with an increased risk of preeclampsia, but the reasons are poorly understood. We hypothesized that a non-physiologic number of corpora lutea (CL) increases the risk of preeclampsia.

Methods:

892 infertile women were enrolled in this prospective cohort study. Four categories based on CL status were defined: (1) absence of the CL; (2) single CL; (3) multiple CL associated with ovulation induction; (4) multiple CL associated with controlled ovarian stimulation for IVF with fresh embryo transfer. Analysis focused on singleton pregnancies conceived with autologous oocytes resulting in live birth (n = 683). Multivariable logistic regression controlled for covariates.

Results:

Compared with conceptions occurring in the presence of one CL, conceptions occurring in the absence of a CL were associated with a higher incidence of preeclampsia (12.8% vs. 4.8%, P= 0.02) and preeclampsia with severe features (9.6% vs. 1.4%, P< 0.001). Compared with FET occurring in the presence of one CL (modified natural cycles), FET occurring in the absence of a CL (programmed cycles) were associated with a higher incidence of preeclampsia (12.8% vs. 3.9%, P= 0.02) and preeclampsia with severe features (9.6% vs. 0.8%, P= 0.002). In multivariable regression models, absence of the CL was predictive for preeclampsia (AOR 2.73; 1.14 – 6.49) and preeclampsia with severe features (AOR 6.45; 1.94 – 25.09) compared to the presence of one CL.

Summary:

Singleton live births conceived in the absence of a CL were at increased risk for development of preeclampsia and preeclampsia with severe features.