Higher gestational weight gain and lower serum estradiol levels on the day of human chorionic gonadotropin administration are associated with increased risk of preeclampsia after in vitro fertilization

Background Very few previous studies have examined the effect of endocrine parameters during ART on preeclampsia. Moreover, there is little known about the relationship of steroid hormone levels on development of the placenta. The purpose of this study is to assess the association of preeclampsia with serum estradiol (E2) and progesterone (P4) levels on the day of human chorionic gonadotropin (hCG) administration during controlled ovarian hyperstimulation (COH) for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods This was a hospital-based cohort study using clinical data from the Kaohsiung Chang Gung Memorial Hospital Obstetric and Neonatal Database (KCGMHOND) from Jan 1, 2001 to December 1, 2018. Eligible women underwent at least one autologous IVF/ICSI cycle and had a live-born infant with a gestational age (GA) of more than 20 weeks. Results A total of 622 women who had live births after fresh IVF/ICSI-ET during the study period met our inclusion criteria. Twenty-eight women (4.5%) met the diagnostic criteria for preeclampsia. However, women in the preeclampsia group had a significantly higher body mass index (22 vs. 24, p =0.05), body weight at delivery (70.0 vs. 80.5 kg, p <0.001) and gestational weight gain (13.0 vs. 19.6 kg, p =0.002) and had lower use of ICSI (29.9% vs. 10.7%, p =0.021). Logistic regression analysis of the relationship of patient and treatment characteristics with preeclampsia. The crude ORs indicated that young female age >34, not using ICSI, E2 peak <1200 pg/mL and gestational weight gain >20 kg were associated with preeclampsia. After adjustment for confounding, the only factors that remained significant were E2 peak <1200 pg/mL (aOR = 4.634, 95% CI = 1.061 to 20.222), and gestational weight gain >20 kg (aOR: 13.601, 95% CI: 3.784, 48.880). Conclusions For women receiving IVF/ICSI, lower estradiol hormone levels on the day of hCG administration and higher pregnancy weight gain are related with subsequent preeclampsia.