Impact of stage 1 hypertension before 20 gestational weeks on pregnancy outcomes in twin pregnancies: a retrospective cohort study.

Autor: Xia Y; Division of Fetal Medicine, Prenatal Diagnosis Department, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China.; Shanghai Municipal Key Clinical Specialty, Shanghai, 200030, China.; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Patrick Manson Building, 7 Sassoon Road, Hong Kong, China., Yang Y; Division of Fetal Medicine, Prenatal Diagnosis Department, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China.; Shanghai Municipal Key Clinical Specialty, Shanghai, 200030, China., Su X; Division of Fetal Medicine, Prenatal Diagnosis Department, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China.; Shanghai Municipal Key Clinical Specialty, Shanghai, 200030, China., Chen Y; School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China., Hua R; Division of Fetal Medicine, Prenatal Diagnosis Department, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China.; Shanghai Municipal Key Clinical Specialty, Shanghai, 200030, China., Gao L; Division of Fetal Medicine, Prenatal Diagnosis Department, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China.; Shanghai Municipal Key Clinical Specialty, Shanghai, 200030, China., Lyu S; Division of Fetal Medicine, Prenatal Diagnosis Department, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China.; Shanghai Municipal Key Clinical Specialty, Shanghai, 200030, China., Tan Y; Division of Fetal Medicine, Prenatal Diagnosis Department, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China.; Shanghai Municipal Key Clinical Specialty, Shanghai, 200030, China., Yang D; Division of Fetal Medicine, Prenatal Diagnosis Department, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China. djyang@shsmu.edu.cn.; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China. djyang@shsmu.edu.cn.; Shanghai Municipal Key Clinical Specialty, Shanghai, 200030, China. djyang@shsmu.edu.cn., Liu L; Division of Fetal Medicine, Prenatal Diagnosis Department, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China. lu.7.liu@kcl.ac.uk.; School of Life Course and Population Sciences, King's College London, London, UK. lu.7.liu@kcl.ac.uk., Wang Y; Division of Fetal Medicine, Prenatal Diagnosis Department, International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China. wyanlin@163.com.; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030, China. wyanlin@163.com.; Shanghai Municipal Key Clinical Specialty, Shanghai, 200030, China. wyanlin@163.com.
Jazyk: angličtina
Zdroj: Hypertension research : official journal of the Japanese Society of Hypertension [Hypertens Res] 2024 Dec 16. Date of Electronic Publication: 2024 Dec 16.
DOI: 10.1038/s41440-024-02001-1
Abstrakt: To explore the association between stage 1 hypertension before 20 weeks of gestation and twin pregnancy outcomes and to examine whether the association varies by prepregnancy BMI, conception mode, or chorionicity, we conducted a single-center, retrospective, hospital-based cohort study. All women who delivered twins between July 2014 and December 2020 were recruited. Logistic regression and linear regression models were used to identify associations. Among the 2069 included twin pregnancies, 1326 had normotension (< 130/80 mm Hg), and 743 had stage 1 hypertension (130-139/80-89 mm Hg). Compared with normotension, stage 1 hypertension was associated with higher risks of hypertension disorders of pregnancy (adjusted OR: 2.07, 95% CI: 1.62 ~ 2.64), gestational hypertension (adjusted OR: 3.99, 95% CI: 2.42 ~ 6.58), preeclampsia (adjusted OR: 1.71, 95% CI: 1.30 ~ 2.25), early preterm birth (adjusted OR: 1.58, 95%CI: 1.16 ~ 2.15), and small for gestational age (adjusted OR:1.45, 95%CI: 1.20 ~ 1.75). In particular, there were interaction effects between chorionicity and stage 1 hypertension on the risk of early preterm birth (P interaction  = 0.014). In conclusion, stage 1 hypertension before 20 weeks of gestation is associated with a higher risk of adverse outcomes in twin pregnancies, and the associations vary by prepregnancy BMI and chorionicity. Obstetricians should take this into careful consideration during prenatal care to mitigate the potential risks of twins.
Competing Interests: Compliance with ethical standards. Conflict of interest: The authors declare no competing interests.
(© 2024. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)
Databáze: MEDLINE
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