{"id":452,"title":"Hypertensive disorders of pregnancy after hormone replacement therapy versus natural cycle frozen embryo transfer: a propensity score-weighted cohort study","title_zh":"激素替代周期与自然周期冻胚移植后妊娠期高血压疾病：倾向评分加权队列研究","url":"https://doi.org/10.21203/rs.3.rs-8437063/v2","doi":"10.21203/rs.3.rs-8437063/v2","pmid":null,"journal":"Research Square","kind":"preprint","lang":"en","published_at":"2026-11-02T00:00:00+00:00","fetched_at":"2026-11-08T03:44:14+00:00","authors":["Goc G","Yıldız GA","Maloku V","Haliti TI"],"primary_topic":"art-clinical","topics":[{"slug":"art-clinical","score":6.0,"hits":["fet","frozen embryo transfer","live birth rate"]},{"slug":"repro-endo","score":2.0,"hits":["ovulation","ovulatory"]},{"slug":"early-pregnancy","score":2.0,"hits":["early pregnancy","pre-eclampsia"]},{"slug":"contraception-health","score":1.0,"hits":["birth rate"]}],"topic_score":6.0,"preference_score":5.0,"preference_labels":["可转化到 ART 实验室的发现"],"llm_score":78.0,"final_score":83.0,"score_dims":{"novelty":65,"rigor":78,"impact":80,"relevance":95,"translation":82},"recommend_reason":"大样本单中心倾向评分加权队列，量化HRT-FET与HDP风险翻倍及活产率降低，对冻胚准备策略和孕期血压监测有直接临床参考；但为预印本单中心观察性研究，需结合随机试验证据谨慎解读。","keywords":["冻融胚胎移植","激素替代周期","自然周期","妊娠期高血压疾病","子痫前期","倾向评分加权"],"selected":1,"story_id":174,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"europepmc-preprints","source_name":"Europe PMC · 预印本（领域内）","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":"research-square","journal_tier":"standard","journal_if":null,"is_mock":false,"summary_zh":"该单中心回顾性队列纳入2012—2024年科索沃2,943个自体冻融胚胎移植周期（HRT 1,208例、自然周期1,735例），并对1,341例单胎活产分析产科结局。采用基于20个变量的倾向评分重叠加权及改良Poisson回归。结果显示，HRT-FET每移植活产率较低（43.4% vs 52.7%，RR 0.82），单胎活产中妊娠期高血压疾病（12.2% vs 5.7%，RR 2.15）和子痫前期（RR 2.08）风险升高，出生体重高89 g。作者认为结果支持可监测排卵时优先自然周期准备，并加强HRT-FET血压监测。","summary":"Abstract Background/aim: Hormone replacement therapy (HRT) for frozen embryo transfer (FET) suppresses the corpus luteum and has been linked to hypertensive disorders of pregnancy (HDP) in registries and randomised trials. We examined this association in a single-center cohort from Kosovo. Materials and methods This retrospective cohort included 2,943 autologous FET cycles (1,208 HRT, 1,735 natural cycle, including modified natural and mild stimulation cycles) at a single center, 2012–2024. Early pregnancy outcomes were analyzed per transfer; obstetric and neonatal outcomes among 1,341 singleton live births. The primary analysis used overlap weighting on a propensity score built from 20 variables. Risk ratios (RR) came from modified Poisson regression with cluster-robust standard errors. Growth categories used sex-specific INTERGROWTH-21st standards. Matching, restriction to 2016–2024, subtype analyses, and alternative specifications served as sensitivity analyses. Results HRT-FET had a lower live birth rate per transfer (43.4% vs 52.7%; RR 0.82, 95% CI 0.74–0.92). Among singleton live births, HRT-FET was associated with more HDP (12.2% vs 5.7%; RR 2.15, 95% CI 1.31–3.54; absolute risk difference + 6.5 percentage points, 95% CI 2.0–11.1) and pre-eclampsia (8.5% vs 4.1%; RR 2.08, 95% CI 1.14–3.80). Matched-pair analysis gave HDP RR 3.86 (95% CI 1.68–8.88). The association persisted in 2016–2024 (RR 1.81, 95% CI 1.01–3.24). Birthweight was 89 g higher after HRT-FET (95% CI 12–166 g); small (RR 1.21, 95% CI 0.57–2.59) and large for gestational age (RR 1.25, 95% CI 0.86–1.81) and other outcomes showed no significant difference; the intervals do not establish equivalence. The E-value for HDP was 3.7. Conclusion HRT-FET was associated with a two-fold higher risk of HDP and a lower live birth rate per transfer than natural cycle FET. The direction agrees with recent randomised trials in ovulatory women. The findings support natural cycle preparation as the first option when ovulation can be monitored, and closer blood pressure surveillance with HRT-FET.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}