Risk of stroke the year following a delivery after using assisted reproductive technologies

Author:

Magnus Maria C.1ORCID,Håberg Siri E.12,Rönö Kristiina3ORCID,Romundstad Liv Bente4,Bergh Christina56,Spangmose Anne Lærke7,Pinborg Anja7,Gissler Mika8910,Wennerholm Ulla‐Britt56,Opdahl Signe1112

Affiliation:

1. Centre for Fertility and Health Norwegian Institute of Public Health Oslo Norway

2. Department of Global Public Health and Primary Care University of Bergen Bergen Norway

3. Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki Finland

4. Spiren Fertility Clinic Trondheim Norway

5. Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

6. Region Västra Götaland Sahlgrenska University Hospital Gothenburg Sweden

7. Fertility Department Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark

8. Finnish Institute for Health and Welfare Helsinki Finland

9. Region Stockholm Academic Primary Health Care Centre Stockholm Sweden

10. Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden

11. Department of Public Health and Nursing Norwegian University of Science and Technology Trondheim Norway

12. Centre for Big Data Research in Health University of New South Wales Kensington Australia

Abstract

AbstractBackgroundStudies indicate that individuals who deliver after assisted reproductive technologies (ART) may have an increased risk of cardiovascular disease (CVD). A recent large study from the U.S. showed a higher risk of stroke during the first year after delivery.ObjectivesTo compare the risk of stroke during the first year after delivery according to the use of ART in the Nordic countries.MethodsRegistry‐based cohort study using nationwide data from Denmark (1994–2014), Finland (1990–2014), Norway (1984–2015) and Sweden (1985–2015). Data on ART conception were available from ART quality registries and/or Medical Birth Registries (MBRs). National data on stroke were available from hospital and cause‐of‐death registries. The risk of stroke during the first year after delivery was estimated with Cox proportional hazard regression, adjusting for age, calendar year of delivery, multiple births, and country.ResultsA total of 2,659,272 primiparous individuals had a registered delivery in the MBRs during the study period, and 91,466 (4%) of these gave birth after ART. We observed no overall increased risk of stroke during the first year after delivery among individuals conceiving after ART (adjusted hazard ratio [HR] 1.10; 95% CI: 0.77, 1.57). Similarly, there was no convincing evidence that the short‐term risk of stroke was higher within 1, 2, 3, or 6 months after delivery, with adjusted HRs ranging between 1.23 and 1.33 and confidence intervals including the null value for all time periods. A secondary analysis also including multiparous individuals (n = 3,335,478) at the start of follow‐up yielded similar findings.ConclusionsWe found no evidence of an increased short‐term risk of stroke among individuals who delivered after using ART.

Funder

Norges Forskningsråd

Publisher

Wiley

Subject

Pediatrics, Perinatology and Child Health,Epidemiology

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