Pre-eclampsia risk raised by infertility treatment and recurrent miscarriage

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Pre-eclampsia risk raised by infertility treatment and recurrent miscarriage
19/12/2008

Key points:
  • Being treated, or having been treated, for infertility may raise the risk of developing pre-eclampsia from 5.2% to 7.0%
  • Recurrent miscarriage (three or more consecutive miscarriages) may raise the risk of developing pre-eclampsia during pregnancy to 8.5%
  • Having recurrent miscarriage and treatment for infertility may the risk to 13.1%

Currently the causes of pre-eclampsia are unknown. However, it is known that pre-eclampsia involves problems with the placenta.

Pre-eclampsia is a condition that causes high blood pressure and raised protein levels in the mother’s urine – both signs of difficulty with the pregnancy. It is a relatively common problem, affecting between 3-10% of pregnancies worldwide. Sometimes it may cause the baby grow slowly and may lead to the life-threatening condition of eclampsia. The only way to stop pre-eclampsia is for the baby to be delivered, which can sometimes mean a premature birth.

It has been found that pre-eclampsia occurs when the placenta fails to develop a strong enough network of arteries to supply oxygen and nutrients to the baby. But the reasons why the development of the placenta’s arterial network may be stunted have not yet been discovered.

It has been thought that the underlying problems that stunt the placenta’s development might be the same as those that cause miscarriage and infertility. So researchers looked at the pregnancies of 20,846 Norwegian women to see if there was a link between the three conditions.

They discovered that women who had not had infertility treatment or recurrent miscarriage (defined as three or more consecutive miscarriages) had a prevalence of pre-eclampsia of 5.2%.

For women who had had infertility treatment, the prevalence of pre-eclampsia increased to 7.0%. Delving deeper into the type of infertility treatment, the use of hormone therapy to stimulate ovulation doubled the risk of pre-eclampsia when compared to women who hadn’t taken hormones.

Women who had had three or more miscarriages (recurrent miscarriage) were at a higher risk of developing pre-eclampsia: the prevalence was 8.5%. Yet those women who had had only one or two miscarriages had no increased risk at all.

The greatest increased risk of developing pre-eclampsia was seen in women who had recurrent miscarriage and had had infertility treatment. For these women, the prevalence of pre-eclampsia was 13.1%.

The results suggest that pre-eclampsia, poor placenta development, infertility and recurrent miscarriage share common causes.


Reference:

Trogstad L, Magnus P, Moffett A, Stoltenberg C. The effect of recurrent miscarriage and infertility on the risk of pre-eclampsia. British Journal of Obstetrics and Gynaecology 2008;116 (1): 108 - 113.



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