Analysis of The Tendency， Characteristic and Risk Factors of Twin Pregnancy Complicated with Preeclampsia
- VernacularTitle:双胎妊娠并发子痫前期的发病趋势、特征及危险因素分析
- Author:
Wei CHEN
1
;
Zi-lian WANG
1
Author Information
1. Department of Obstetrics & Gynecology， The First Affiliated Hospital， Sun Yat-sen University， Guangzhou 510080，China
- Publication Type:Journal Article
- Keywords:
twin pregnancy;
preeclampsia;
risk factors;
delivery outcomes
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(1):145-153
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the tendency， characteristic and risk factors of twin pregnancy complicated with preeclampsia. MethodsA retrospective analysis was performed on the incidence trend of preeclampsia in 1542 twin pregnant women who were hospitalized for delivery in the First Affiliated Hospital of Sun Yat-sen University from January 2011 to December 2019. Finally， 1384 twin pregnant women were included in the analysis of subsequent morbidity characteristics and risk factors， who were divided into Monochorionic （MC） group and Dichorionic （DC） group according to chorionicity. There were 403 MC cases， including 55 cases in Preeclampsia （PE） group and 348 cases in non-PE group and 981 DC cases， including 105 cases in PE group and 876 cases in non-PE group. The basic characteristics and delivery outcomes of different chorionic pregnant women in PE group and non-PE group were compared respectively. Univariate analysis and multivariate Logistic regression analysis were used to analyze the risk factors of preeclampsia in different chorionic twin pregnancies. ResultsThe total incidence of PE in twin pregnancies was 10.4%， the incidence of PE in twin pregnancies from 2011 to 2019 varied between 7.8% and 11.8%. Regardless of MC and DC twin pregnancies， the incidence of anemia （MC： 58.2% vs 39.7%， P=0.010； DC： 59% vs 38%， P=0.000）， hypoproteinemia （MC： 7.3% vs 1.7%，P=0.035； DC： 10.5% vs 0.7%， P=0.000）， premature delivery （MC： 94.5% vs 70.1%， P=0.000； DC： 89.5% vs 54.8%， P=0.000）， postpartum hemorrhage （MC： 21.8% vs 10.6%， P=0.018； DC： 20.9% vs 13.4%， P=0.035）， neonatal transfer to intensive care unit （MC： 49.1% vs 28.6%， P=0.000； DC： 26.7% vs 15.6%， P=0.000） in pregnant women in PE group was higher than that in non-PE group， the difference between the two groups were statistically significant. the birth weight of both small fetuses and large fetuses in PE group of DC twins was lower than that in the non-PE group， the difference between these two groups were also statistically significant（P=0.000； P=0.017）. Excessive weight gain during pregnancy and assisted reproductive technology for conception were independent risk factors for MC twin PE. Pre-pregnancy BMI≥24 kg/m2， excessive weight gain during pregnancy and excessive weight difference were independent risk factors for PE in DC twins. ConclusionsThe incidence of PE in twin pregnancies fluctuates between 7.8% and 11.8% in each year. The outcomes of PE in different chorionic twin pregnancy are slightly different. Excessive weight gain during pregnancy， assisted reproductive technology for conception， Pre-pregnancy BMI≥24 kg/m2 and excessive weight difference of the twins during pregnancy are risk factors for PE in twin pregnancies， suggesting weight management during pregnancy is particularly important.
