Oocyte Donation Pregnancies and the Risk of Preeclampsia or Gestational Hypertension: A Systematic Review and Meta analysis
The objective of this study was to conduct a systematic review andmeta analysis of published literature to establish whether the risk of preeclampsia or gestational hypertension was increased when pregnancies were achieved through oocyte donation rather than through other assisted reproductive technology methods or natural conception. Through literature review, specific eligibility criteria, and quality assessment using theMethodological Index for Non Randomized Studies (MINORS) 19 of the 523 comparative studies were examined. The data from the selected studies covering 86,515 pregnancies revealed a higher risk of preeclampsia in pregnancies that involved oocyte donation when compared with other assisted reproductive technology methods (odds ratio, 2.54; 95% confidence interval, 1.98 3.24; P 0.0001) or natural conception (odds ratio, 4.34; 95% confidence interval, 3.10 6.06; P 0.0001) A similar increased risk was also observed in the case of gestational hypertension in oocyte donation pregnancies as opposed to natural conception or other assisted technologies. This study concludes that oocyte donation may be an independent risk factor in development of gestational hypertensive disorders, especially preeclampsia. Other important confounders in this patient population to the outcome were identified and accounted for before identifying the increased risk of hypertensive disorders. The conclusion regarding the increased risk gestational hypertension (13 studies) and preeclampsia (15 studies) was supported by subgroup analysis of both singleton and multiple gestations. Meta analysis of the data, including funnel plot and forest plot, reinforces the increased risk in oocyte donation pregnancies, and this should be considered during preconception counseling so as to facilitate an informed choice as well as increased monitoring after 20 weeks of gestation in such cases.