Cardiovascular complications of traditional vs surrogate pregnancy

Surrogacy utilises assisted reproductive technology including artificial intrauterine insemination, in-vitro fertilization (IVF), and frozen embryo transfer to help achieve parenthood. The differences in adverse cardiovascular outcomes of surrogate pregnancy compared to traditional pregnancy are not well studied.

Pregnant patients were procured from the National Inpatient Sample database. Patients were stratified into surrogate and non-surrogate pregnancy groups. The primary outcome was major adverse cardiovascular event (MACE), conduction abnormalities, pre-eclampsia, gestational diabetes (GDM), and mortality. Secondary outcomes included individual components of MACE, individual components of conduction abnormalities, spontaneous coronary artery dissection, aortic dissection, Takotsubo cardiomyopathy, and length of hospital stay.

Of 1,942,429 pregnant patients, 3,922 were surrogate patients. Surrogate patients tended to be older and have higher Caucasian prevalence. MACE rates were similar between both groups. Surrogate carriers had increased conduction abnormalities, bundle branch blocks, supraventricular tachycardia, ventricular tachycardia, pre-eclampsia, GDM, and an increased length of hospital stay relative to non-surrogate patients. After multivariate analysis, surrogate carriers had elevated risk for conduction abnormalities, pre-eclampsia, and gestational diabetes. No differences in outcomes were found when comparing traditional surrogacy vs gestational surrogacy.

Surrogate carriers were more likely to have conduction abnormalities, pre-eclampsia, and GDM, and increased length of hospital stay with similar rates of MACE when compared to non-surrogate carriers. Surrogate pregnancy appears to be a safe and appealing option for women struggling with fertility, however, consideration should be given to the incorporation of dedicated cardiovascular care into the routine follow-up of these patients.