Maternal cardiovascular adaptation to twin pregnancy: a population-based prospective cohort study.

Autor: Adank MC; Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands. m.adank@erasmusmc.nl.; Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands. m.adank@erasmusmc.nl., Broere-Brown ZA; Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.; Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands., Gonçalves R; Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.; Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands., Ikram MK; Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.; Department of Neurology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands., Jaddoe VWV; Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.; Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.; Department of Paediatrics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands., Steegers EAP; Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands., Schalekamp-Timmermans S; Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.; Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.
Jazyk: angličtina
Zdroj: BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2020 May 29; Vol. 20 (1), pp. 327. Date of Electronic Publication: 2020 May 29.
DOI: 10.1186/s12884-020-02994-w
Abstrakt: Background: In women with singleton pregnancies, maternal adaptation is considered a stress test for later life cardiovascular disease. The aim of this study was to assess maternal adaptation in women with twin pregnancies compared to women carrying singletons during and after pregnancy.
Methods: This was a population based prospective cohort study of 91 women with twin pregnancies and 8107 women carrying singletons. The association of twin pregnancy and maternal adaptation was examined using regression analyses. In pregnancy, we measured soluble fms-like tyrosine kinase-1 (sFLT-1), placental growth (PGF) factor, systolic (SBP) and diastolic blood pressure (DBP), and the occurrence of pre-eclampsia (PE). After pregnancy, measurements were obtained on SBP and DBP, cardiac function, retinal calibres, intima media thickness and distensibility of the common carotid artery.
Results: sFLT-1 and PGF concentrations were higher in early (13.4 weeks) and mid-pregnancy (20.4 weeks) in women with twin pregnancies compared to women with singleton pregnancies. Women with twin pregnancies had a different DBP pattern in pregnancy. Women with twin pregnancies were more likely to have PE (odds ratio 3.63; 95% CI [1.76 to 7.48]). Six and ten years after pregnancy, no differences in maternal adaptation were observed.
Conclusions: Women with twin pregnancies show an altered adaptation during pregnancy compared to women with singleton pregnancies. This is associated with a substantially increased incidence of PE, but does not lead to persistent altered maternal adaptation years after pregnancy.
Databáze: MEDLINE
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