Placenta pathology in recipient versus donor oocyte derivation for in vitro fertilization in a setting of hypertensive disorders of pregnancy and IUGR
| Autor: | Ken Tang, Sonia Dancey, Dina El Demellawy, Erika Mery, Shannon Bainbridge, Ashley Esteves, Irina Oltean, Lamia M Hayawi |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
0301 basic medicine Gestational hypertension Pathology medicine.medical_specialty Placenta Diseases Placenta medicine.medical_treatment Population Intrauterine growth restriction Gestational Age Fertilization in Vitro Preeclampsia 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans education reproductive and urinary physiology Retrospective Studies education.field_of_study Fetal Growth Retardation 030219 obstetrics & reproductive medicine In vitro fertilisation business.industry Pregnancy Outcome Obstetrics and Gynecology Gestational age Hypertension Pregnancy-Induced medicine.disease 3. Good health 030104 developmental biology Reproductive Medicine Female business Villitis of unknown etiology Developmental Biology |
| Zdroj: | Placenta. 108:114-121 |
| ISSN: | 0143-4004 |
| DOI: | 10.1016/j.placenta.2021.03.012 |
| Popis: | Introduction Assisted reproductive technology including in vitro fertilization (IVF) and oocyte donation (OD) may increase risk for placenta-mediated diseases. Comprehensive analysis of histopathological placental lesions according to source of oocytes used in the IVF procedure – recipient derived (RD-IVF) vs oocyte donation (OD-IVF), has not been conducted in a population with a hypertensive disorder of pregnancy (HDP) and/or intrauterine growth restriction (IUGR). Methods A retrospective cohort study of archived placenta specimens from RD-IVF and OD-IVF pregnancies affected by HDP and/or IUGR was conducted with blinded histopathological placental examination. Three categories of lesions were differentiated and defined as main outcomes: maternal vascular malperfusion (MVM), chronic inflammation, and fetal vascular malperfusion (FVM). To determine the relationship between conception method and placental lesions, multivariable regressions were performed with maternal age, gestational age, HDP, birth and placental weight percentiles as model covariates. Results 115 placentas were included 83 (72.2%) RD-IVF, 32 (27.8%) OD-IVF. Adjusted OR (aOR) for conception method was 5.05 (95%CI 0.58–43.90, p=0.142) for MVM, 1.87 (95%CI 0.68–5.15, p=0.228) for chronic inflammatory and 0.61 (95%CI 0.15–2.37, p=0.471) for FVM lesions. Multiple gestation demonstrated borderline association with MVM (aOR=0.24, 95%CI 0.04–1.51, p=0.129) and total pathology score (aRR=0.79, 95%CI 0.62–1.01, p=0.058). Subgroup analysis suggested greater odds of villitis of unknown etiology (VUE) for OD-IVF (aOR=2.98, 95%CI 1.12–7.93, p=0.029). Discussion Source of oocyte derivation demonstrated no evidence of association with main outcomes in cases of HDP and/or IUGR. Subgroup analysis demonstrated increased rates of inflammatory lesions for OD-IVF. Multiple gestation may be associated with decreased MVM and total lesions. |
| Databáze: | OpenAIRE |
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