IVF Children at Higher Risk of Developing Hypertension

IVF Children at Higher Risk of Developing Hypertension

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Highlights:
  • Children born by assisted reproductive technology (ART) are found to be at an increased risk of developing high blood pressure and other heart related complications earlier in life
  • Close monitoring of blood pressure in these children is important and effective treatment and interventions must be initiated early to prevent complications
  • ART has helped several individuals and families who are unable to conceive a baby naturally. Currently, there are over six million babies born through ART, worldwide
Babies born through assisted reproductive technologies (ART) such as in vitro fertilization (IVF) may be at higher risk of developing high blood pressure and other heart complications earlier in life, according to a recent Swedish study that appears in the Journal of the American College of Cardiology.

Assessment of Hypertension Risk In ART Children

Children born through ART comprise 1.7 percent of all babies born in the US annually and currently, there are more than six million persons across the world. The most commonly used ART techniques are in vitro fertilization (IVF) and intracytoplasmic sperm injection.
IVF Children at Higher Risk of Developing Hypertension

In these techniques, the egg and sperm are fertilized outside the body in the lab, thus exposing the reproductive cells (egg and sperm) as well as the fertilized embryo to many environmental factors before implantation into the uterus.

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The aim of the study is to find out possible effects of environmental influences before implantation of the fertilized embryo on the heart health of these children such as the development of hypertension.

Monitoring Blood Pressure in Adolescents Born via ART
  • The study included 54 adolescent children conceived by assisted reproductive techniques (ART) and 43 age and sex-matched control participants (conceived naturally) for comparison. Parameters such as body mass index (BMI), birth weight, gestational age, and maternal BMI, cardiovascular risk profile and smoking history were similar in the two groups
  • The study team assessed the otherwise young and healthy ART children (mean age 16) by measuring 24 hour ambulatory (while the person is moving around and carrying on with routine daily activities) blood pressure, and the health of blood vessels by checking for blood vessel stiffness and accumulation of fatty plaques in the wall of the blood vessel resulting in narrowing of blood vessels
  • The ambulatory blood pressure monitoring found that ART adolescents had both a larger systolic and diastolic blood pressure (119/71 mmHg) compared to control participant at 115/69 mmHg
  • Most importantly, eight of the ART children satisfied the criteria for making a diagnosis of arterial hypertension (over 130/80 mmHg) whereas only one of the control participants satisfied the criteria
"The increased prevalence of arterial hypertension in ART participants is what is most concerning," said Emrush Rexhaj, MD, director of Arterial Hypertension and Altitude Medicine at Inselspital, University Hospital in Bern, Switzerland and the lead author of the study. "There is growing evidence that ART alters the blood vessels in children, but the long-term consequences were not known. We now know that this places ART children at a six times higher rate of hypertension than children conceived naturally."
  • Arterial blood pressure measured in the participants five years before this study found that the arterial blood pressure between ART and control children was not different at this time
"It only took five years for differences in arterial blood pressure to show," Rexhaj said. "This is a rapidly growing population and apparently healthy children are showing serious signs of concern for early cardiovascular risk, especially when it comes to arterial hypertension."

Thus, the findings of the study suggest that ART children might be at a higher risk for early onset hypertension and associated heart disease.

Possible Limitations of the Study

  • Only single ART births were selected for study
  • Premature births, low birth weight and preeclampsia (high blood pressure of woman during pregnancy), which are known risk factors of heart disease were excluded from the study
  • Participants were selected from the same reproductive center
In an editorial accompanying the study, Larry A. Weinrauch, MD, cardiologist at Mount Auburn Hospital adds that the small number of participants in this study as well as not including ART participants who were multiple births or whose mothers had diabetes and/or hypertension during pregnancy (known risk factors of heart disease) might have underestimated the degree of the problem (hypertension) in ART children in the general population.

Physicians must be alert to the possibility of early onset hypertension in ART adolescents and closely monitor the blood pressure and initiate measures such as diet and lifestyle changes and medications if necessary to prevent heart complications later in life.

References :
  1. Théo A.Meister, Stefano F.Rimoldi, Rodrigo Soria, Robert von Arx, Franz H.Messerli, ClaudioSartori, Urs Scherrer, Emrush Rexhaj., "Association of Assisted Reproductive Technologies With Arterial Hypertension During Adolescence" Journal of the American College of Cardiology Volume 72, Issue 11, 11 September (2018), Pages 1267-1274 https://doi.org/10.1016/j.jacc.2018.06.060
  2. Expert Reaction to Children Born Through IVF and Risk of Hypertension as Published In Journal of the American College of Cardiology - (http://www.sciencemediacentre.org/expert-reaction-to-children-born-through-ivf-and-risk-of-hypertension-as-published-in-journal-of-the-american-college-of-cardiology/)
  3. Birth Through IVF May Increase Hypertension Risk - (https://www.acc.org/latest-in-cardiology/articles/2018/08/31/11/21/birth-through-ivf-may-increase-hypertension-risk)


Source: Medindia

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