Birth Through IVF May Increase Hypertension Risk

Children conceived through assisted reproductive technologies (ART) may be at an increased risk of developing arterial hypertension early in life, among other cardiovascular complications, according to a study published Sept. 3 in the Journal of the American College of Cardiology.

The most common ART methods are in vitro fertilization and intracytoplasmic sperm injection, which can expose the gamete and embryo to a variety of environmental factors before implantation. Children conceived using ART make up 1.7 percent of all infants born in the U.S. every year and currently over six million persons worldwide.

Emrush Rexhaj, MD, et al., assessed the circulatory system of 54 young, healthy ART adolescents (mean age 16) by measuring ambulatory blood pressure, as well as plaque build-up, blood vessel function and artery stiffness. Body mass index, birth weight, gestational age, maternal BMI, smoking status and cardiovascular risk profile were similar between the ART adolescents and 43 age- and sex-matched control participants.

Through 24-hour ambulatory blood pressure monitoring, researchers discovered that ART adolescents had both a higher systolic and diastolic blood pressure than the control participants of natural conception at 119/71 mm Hg vs. 115/69 mm Hg, respectively. Most importantly, eight of the ART adolescents reached the criteria for the diagnosis of arterial hypertension (over 130/80 mm Hg) whereas only one of the control participants met the criteria. The authors also studied these participants five years before this study and found that the arterial blood pressure between ART and control children was not different.

Limitations of this study include that only single-birth children were studied, as well as that participants were recruited from one procreation center. Prematurity, low birth weight and preeclampsia (all known cardiovascular risk factors) were excluded from the study. These limitations may have resulted in a lower cardiovascular risk among the participants compared with the overall ART population.

In an accompanying editorial, Larry A. Weinrauch, MD, said that the study's small cohort may understate the importance of this problem for ART adolescents, especially since multiple birth pregnancies and maternal risk factors (such as eclampsia, chronic hypertension and diabetes) were excluded from the study.

"Early study, detection and treatment of ART conceived individuals may be the appropriate course of preventative action," Weinrauch wrote. "We need to be vigilant in the development of elevated blood pressure among children conceived through ART to implement early lifestyle-based modifications and, if necessary, pharmacotherapy."

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Prevention, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Hypertension

Keywords: Pregnancy, Birth Weight, Body Mass Index, Gestational Age, Pre-Eclampsia, Risk Factors, Blood Pressure Monitoring, Ambulatory, Infant, Low Birth Weight, Fertilization in Vitro, Multiple Birth Offspring, Maternal Age, Hypertension, Diabetes Mellitus, Germ Cells, Arteries, Life Style, Cohort Studies

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