Abstract
BackgroundPreeclampsia is a common obstetric complication. The rate of preeclampsia is increased in twin pregnancies. The aim of this study was to assess the clinical risk factors for developing preeclampsia in twin pregnancies.MethodsA case-control study was carried out among women with twin pregnancies who delivered at gestational age more than 23 weeks at King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, from 2003 to 2019. The data were retrieved from electronic medical records. Multivariate logistic regression analysis was used to find the risk factors.ResultsA total of 1,568 twin pregnancies were delivered during the study period and 182 cases (11.6%) developed preeclampsia. 172 cases with preeclampsia and 516 controls were selected for analysis. After certain variables were adjusted in the multivariate logistic regression analysis, the clinical factors associated with preeclampsia in twin pregnancies were nulliparity (adjusted odds ratio (OR) 1.57, 95% confidence interval (CI) 1.02–2.41) and chronic hypertension (adjusted OR 6.22, 95%CI 1.98–19.57). Low gestational weight gain was a significant protective factor against the development of preeclampsia (adjusted OR 0.50; 95%CI 0.32–0.77).ConclusionThe clinical risk factors for developing preeclampsia in twin pregnancies were nulliparity and chronic hypertension. These risk factors are of value to identify twin pregnant women at risk for preeclampsia and in implementing primary prevention.
Highlights
Hypertensive disorders in pregnancy constitute one of the leading causes of maternal and perinatal mortality worldwide
A total of 1,568 twin pregnancies were delivered during the study period and 182 cases (11.6%) developed preeclampsia. 172 cases with preeclampsia and 516 controls were selected for analysis
After certain variables were adjusted in the multivariate logistic regression analysis, the clinical factors associated with preeclampsia in twin pregnancies were nulliparity (adjusted odds ratio (OR) 1.57, 95% confidence interval (CI) 1.02–2.41) and chronic hypertension
Summary
Hypertensive disorders in pregnancy constitute one of the leading causes of maternal and perinatal mortality worldwide. There are various risk factors that increase the probability of preeclampsia and a multifetal gestation is one of the risk factors [1]. The rate of preeclampsia is higher than singleton and overall rate is around 9.5%, about two- to three-fold increased risk compared to singleton [2]. Preeclampsia in twins has been reported to occur at earlier gestational age and has more severe form [3]. The reasons why twins developed preeclampsia more than singleton are still inconclusive. It has been proposed that the pathogenesis of preeclampsia among twin pregnancies may be due to a higher immunologic response and placental mass [4]. The rate of preeclampsia is increased in twin pregnancies. The aim of this study was to assess the clinical risk factors for developing preeclampsia in twin pregnancies
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