(884) Association of IVF with Preeclampsia with Severe Features Among Very Advanced Maternal Age Patients

Retrospective cohort study of vAMA patients who delivered at a large academic health system in New York between January 2019 and December 2022. vAMA was defined as ≥ 45 years old at delivery. Rates of sPEC and other hypertensive disorders of pregnancy were determined for IVF versus non-IVF patients. A multivariate logistic regression was used to estimate the relationship between IVF and sPEC while controlling for obesity, nulliparity, race and ethnicity, public insurance, and primary language using R version 4.3.1. A p-value of < 0.05 was considered statistically significant. 




Results: A total of 591 vAMA pregnancies were included, of which 218 (37%) were IVF pregnancies and 373 (63%) were non-IVF pregnancies.  Rates of hypertensive disorders were similar between groups (24.7% in the non-IVF cohort and 29.4% in the IVF cohort, p=0.212). The sPEC rate among IVF vAMA patients IVF was 16.1%, compared to 9.7% in the non-IVF group (p = 0.021). IVF was associated with an increased likelihood of sPEC among vAMA patients in an unadjusted model, OR 1.79 (95% CI, 1.09 - 2.95); however this was not the case after adjusting for potential confounders, aOR 1.57 (95% CI 0.92 - 2.67).

Conclusion: Although vAMA and IVF have each been independently associated with an increased risk of sPEC, this is the first study to evaluate whether IVF is specifically linked to an increased risk of sPEC and hypertensive disorders of pregnancy in vAMA patients. In this cohort of patients with vAMA, IVF did not independently increase the risk of sPEC or hypertensive disorders of pregnancy.