Incidence of hypertension, stroke, coronary heart disease, and diabetes in women who have delivered after in vitro fertilization: a population-based cohort study from Sweden
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Objective To compare the incidence of hypertension, stroke, coronary heart disease, and diabetes in women who have delivered after in vitro fertilization (IVF) with those who delivered after natural conception.Design A cohort study in Sweden between 1990 and 2008.Setting Sweden.Patient(s) 23,498 women who had given birth to a child after IVF and 116,960 individually matched women.Intervention(s) None.Main outcome measure(s) Incidence rates of hypertension, diabetes, stroke, and coronary heart disease in both groups.Result(s) Inpatient and outpatient diagnoses of hypertension, stroke, coronary heart disease, and diabetes were identified by linkage to the Swedish National Patient Register. The mean time of follow-up was 8.6 years in both groups. Multivariable analysis showed that hypertension had a higher incidence in IVF mothers with a hazard ratio (HR) of 1.27, 95% confidence interval (CI) 1.13-1.41, as compared with mothers from the Medical Birth Register. There was a trend to a higher incidence of stroke (HR 1.27; 95% CI, 0.96-1.68), but the incidence of coronary heart disease and diabetes did not differ.Conclusion(s) Hypertension was more prevalent in the IVF group, which suggests that these women should be aware of their blood pressure and cardiovascular risk profile.
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Repeated cycles of ovarian hyperstimulation and associated hyperestrogenemia may cause endothelial injury by affecting the renin-angiotensin system.
“Repeated cycles of ovarian hyperstimulation and associated hyperestrogenemia contribute to a prothrombotic state (23) and may also cause endothelial injury by affecting the renin-angiotensin system (24,25).”
From Cardiovascular Risk Following Fertility Therapy (2017) · cites this paper as [24]
Both IVF and non-IVF approaches often involve repeated cycles of high-dose hormonal stimulation protocols, which lead to potential fluid shifts, endothelial dysfunction, and a prothrombotic state.
“Both IVF and non-IVF approaches often involve repeated cycles of high-dose hormonal stimulation protocols, which lead to potential fluid shifts, endothelial dysfunction, and a prothrombotic state (23)(24)(25).”
From Cardiovascular Risk Following Fertility Therapy (2017) · cites this paper as [24]
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References 33 · Cited by 60
Research works printed but not linked: 1
- Irgens HU, Reisaeter L, Irgens LM, Lie RT. Long term mortality of mothers and fathers after pre-eclampsia: population based cohort study. BMJ 2001;323: 1213-7.
- Authors
- Westerlund, E., Brandt, L., Hovatta, O., Wallén, H., Ekbom, A., & Henriksson, P.
- Affiliations
- Danderyds sjukhus (SE)
- Karolinska University Hospital (SE)
- Corresponding author
- Westerlund, Eli
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2014-10
- Volume
- 102
- Issue
- 4
- Pages
- 1096-1102
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2076994379
- Cited by
- 60
- References
- 33
- Citations by year
- 2026: 8 · 2025: 4 · 2024: 8 · 2023: 5 · 2022: 6 · 2021: 5 · 2020: 6 · 2019: 3 · 2018: 4 · 2017: 5 · 2016: 2 · 2015: 4
- FWCI
- 4.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Funders
- AstraZeneca
- Karolinska Institutet
- Stockholms Läns Landsting
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- in vitro fertilization, hypertension, stroke, coronary artery disease, diabetes mellitus, cardiovascular risk, women of reproductive age, spontaneous conception, incidence, assisted reproduction
- MeSH terms
- Adult, Coronary Disease, Diabetes Mellitus, Female, Fertilization in Vitro, Humans, Hypertension, Middle Aged, Pregnancy, Registries, Risk Factors, Sweden, Time Factors, Incidence, Prevalence, Multivariate Analysis, Chi-Square Distribution, Proportional Hazards Models, Case-Control Studies, Stroke, Live Birth, Young Adult
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