Study of the pulmonary arterial pressure in at-term in vitro fertilization neonates: A cross-sectional study

Objective: Consumption of different hormones by the mothers who become pregnant through in vitro fertilization (IVF), as well as manipulations at the embryonic period have all raised concerns regarding the neonates' health including the possibility of pulmonary hypertension. This study, therefore, aimed to assess the pulmonary arterial pressure in at-term IVF neonates.

Materials and Methods
In this prospective cross-sectional study carried out during March 2013 to October 2017, 160 IVF neonates (Group 1) were compared to 160 others as their natural pregnancy counterparts (Group 2).
All the neonates in both groups were selected from the cesarean newborns and matched in terms of gestational and neonatal age. The neonates's age was 3-7 days, and all were full term with gestational age of 37-39 weeks and 6 days with normal birth weight (2500-4000 g). systolic pulmonary artery pressure (SPAP) was estimated with real time echocardiography on the basis of peak flow velocity of tricuspid regurgitation jet.

Results
A significant difference was identified regarding the mean SPAP between the two groups (P<0.001). The effect of gestational age on reducing SPAP was greater in group 1, which turned out to be statistically significant. Moreover, the gradual decrease in pulmonary artery pressure after birth appeared slower in Group 1. The effect of gestational age on reducing SPAP was more cogent than that of neonatal age on SPAP in both Groups. There was, further, a significant reverse correlation between SPAP and neonatal weight in both groups; however, it markedly appeared higher in Group 1.

Conclusion
Our study renders IVF as being culpable in the incidence of pulmonary hypertension in neonates. Hence, IVF neonates are recommended to have monitoring of pulmonary artery pressure undertaken during the neonatal period so as to detect in them the likelihood of pulmonary arterial hypertension and, resultantly, provide them with required treatment.