Assessing In-Hospital Stroke Risk in Pregnant Patients Using Assisted Reproductive Technologies: Ava L. Liberman, MD

WATCH TIME: 4 minutes

"Patients who are thinking about undergoing ART and have known vascular risk factors—we should address those in the established ways that we know how to, as primary prevention for stroke is important."

The use of assisted reproductive technology (ART) is defined as in vitro fertilization and related methods, which is accounted for approximately between 1.5% and 2% of all births in the United States.¹ Despite being regarded as a safe procedure for pregnancy, previous research revealed hypertensive disorders, severe ovarian hyperstimulation syndrome, and venous thromboembolism in association with the use of ART. In recent studies evaluating the association of ART with cerebrovascular events, investigators observed that patients who conceived using ART were older with a higher burden of cardiovascular comorbidities compared with those who conceive spontaneously.²

Presented at the 2024 International Stroke Conference (ISC), held February 7-9, in Phoenix, Arizona, a recent retrospective cohort study showed an increased risk of in-hospital stroke among patients hospitalized for delivery in the United States who used ART compared with nonART users.³ In this study, senior author Ava L. Liberman, MD, and colleagues used data on delivery hospitalizations for patients aged between 15 and 55 years from the National Inpatient Sample registry between 2015 and 2020. The primary end point was stroke during index delivery hospitalization and secondary end points were the individual stroke subtypes.

Liberman, medical director of the Stroke Center and assistant professor of neurology at Weill Cornell Medicine, sat down with NeurologyLive® during the meeting to further discuss the key outcomes investigated in the study. She shared how the acknowledged limitations of the study potentially impact the validity of the conclusions drawn regarding the association between ART and stroke risk. In addition, Liberman explained the ways the study's findings can influence medical advice prescribing methods given by clinicians for patients contemplating ART use.

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REFERENCES
1. Toner JP, Coddington CC, Doody K, et al. Society for Assisted Reproductive Technology and assisted reproductive technology in the United States: a 2016 update. Fertil Steril. 2016;106(3):541-546. doi:10.1016/j.fertnstert.2016.05.026
2. Sachdev D, Yamada R, Lee R, Sauer MV, Ananth CV. Risk of Stroke Hospitalization After Infertility Treatment. JAMA Netw Open. 2023;6(8):e2331470. Published 2023 Aug 1. doi:10.1001/jamanetworkopen.2023.31470
3. Dicpinigaitis AJ, Seitz A, Berkin J, et al. Association of Assisted Reproductive Technology and Stroke During Hospitalization for Delivery in the United States. Presented at: International Stroke Conference; February 7-9, 2024; Abstract 11.