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The 'immunologic theory' of preeclampsia revisited: a lesson from donor oocyte gestations.

Abstract：

OBJECTIVE:To determine the prevalence of placental complications in patients conceived through donor versus autologous oocytes. STUDY DESIGN:A retrospective cohort study including 2 groups of patients who conceived through in vitro fertilization using: (1) donor oocyte (n = 139) and (2) autologous oocyte (n = 126). Only singleton gestations were included. The rate of placental complications including preeclampsia, gestational hypertension, and intrauterine growth restriction was compared between these 2 groups. RESULTS:The women who conceived using donor oocytes were older compared with women who conceived using autologous oocytes (median maternal age 45 vs 41, P < .01). The rate of hypertensive diseases of pregnancy including gestational hypertension and preeclampsia was significantly higher in ovum donor recipients compared with women conceived with autologous oocytes (25% vs 10%, P < .01). Similarly, the rate of intrauterine growth restriction was also higher among patients conceived through oocyte donation although it did not reach statistical significance (9.3% vs 4%, P = .08). When maternal age was restricted to ≤45 years, the rate of hypertensive diseases of pregnancy remained significantly higher among ovum donor compared with autologous oocyte recipients (22% vs 10%, P = .02). Adjustment for maternal age, gravidity, parity, and chronic hypertension revealed that oocyte donation was independently associated with higher rate of hypertensive diseases of pregnancy (P = .01). CONCLUSION:Patients conceived through oocyte donation have an increased risk for placental complications of pregnancy. These findings support the 'immunologic theory' suggesting that immunologic intolerance between the mother and the fetus may play an important role in the pathogenesis of preeclampsia.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Levron Y,Dviri M,Segol I,Yerushalmi GM,Hourvitz A,Orvieto R,Mazaki-Tovi S,Yinon Y

doi

10.1016/j.ajog.2014.03.044

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

383.e1-5

issue

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(14)00272-5

journal_volume

211

pub_type

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The 'immunologic theory' of preeclampsia revisited: a lesson from donor oocyte gestations.