Risk assessment of hypertensive disorders of pregnancy and other adverse pregnancy outcomes after frozen embryo transfers following an artificial cycle: A retrospective cohort study

Author:

Pohjonen Eeva‐Maria12ORCID,Huhtala Heini3ORCID,Erkinaro Tarja4,Lehto Johanna5,Pellas Elena6,Vilmi‐Kerälä Tiina7ORCID,Laivuori Hannele128ORCID,Ahinko Katja1ORCID

Affiliation:

1. Department of Obstetrics and Gynecology, Tampere University Hospital Wellbeing Services County of Pirkanmaa Tampere Finland

2. Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research Tampere University Tampere Finland

3. Faculty of Social Sciences Tampere University Tampere Finland

4. Department of Obstetrics and Gynecology Satasairaala Central Hospital Pori Finland

5. Department of Obstetrics and Gynecology Seinäjoki Central Hospital Seinäjoki Finland

6. Department of Obstetrics and Gynecology Vaasa Central Hospital Vaasa Finland

7. Department of Obstetrics and Gynecology Kanta‐Häme Central Hospital Hämeenlinna Finland

8. Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science University of Helsinki Helsinki Finland

Abstract

AbstractObjectivesThe primary aim was to investigate if frozen embryo transfer (FET) without a corpus luteum increases the risk of hypertensive disorders of pregnancy (HDP). The secondary aim was to investigate other adverse maternal and perinatal outcomes.MethodsThis was a retrospective cohort study of 1168 singleton pregnancies and live births following a FET with either an artificial cycle (AC‐FET) (n = 631) or a natural/modified natural/stimulated cycle (CL‐FET) (n = 537) between 2012 and 2020. The data were collected from patient records. The primary outcome was HDP. Secondary outcomes included cesarean sections, placental retention problems, postpartum hemorrhage (PPH), the duration of pregnancy, birth weight, low birth weight, macrosomia, length of gestation, preterm birth, small for gestational age, and large for gestational age.ResultsIn the AC‐FET group, there was an increased incidence of pre‐eclampsia, gestational hypertension, cesarean sections, PPH over 500 and 1000 mL, and retained placental tissue, compared with the CL‐FET group. These associations remained significant in logistic regression analyses with clinically relevant adjustments.ConclusionThe risk of HDP and several other maternal complications seems to be increased after AC‐FET compared with CL‐FET. Our findings support most earlier studies regarding HDP and add to the knowledge on other maternal and perinatal risks involved in AC‐FET, including an increased risk of milder forms of placental retention. More studies are needed to confirm these findings.

Publisher

Wiley

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