Risk Factors for Preeclampsia in Twin Pregnancies

Fox, Nathan S.; Roman, Ashley S.; Saltzman, Daniel H.; Hourizadeh, Tanya; Hastings, Jeffrey W.; Rebarber, Andrei

doi:10.1055/s-0033-1343775

Cited by 17 publications

(13 citation statements)

References 16 publications

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“…Meanwhile, risk factors associated with PE or IUGR in singleton pregnancy had inability to predict PE or IUGR in twin pregnancy (aside from obesity and egg donation for PE). [ 4 23 24 ] …”

Section: Discussionmentioning

confidence: 99%

“…Recently, multiple studies have focused on the incidence and risk factors of twin pregnancies with PE, [ 4–8 ] but inadequate data exist regarding the clinical characteristics and perinatal outcomes of twin pregnancies with PE. [ 9–12 ] It is acknowledged that PE increases the risk of adverse maternal–neonatal outcomes mainly from data of singleton pregnancies.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics of fetal and neonatal outcomes in twin pregnancy with preeclampsia in a retrospective case–control study

Tan

Wang²,

Li³

et al. 2016

Medicine

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The aim of our study was to compare the clinical characteristics of fetal and neonatal outcomes in twin pregnancies between women with preeclampsia (PE) and those with normotension in a Chinese population.There were 143 preeclamptic women and 367 normotensive women with twin pregnancies included in this retrospective case–control study. The baseline characteristics and perinatal outcomes were collected and compared between the groups. Multiple logistic regression and linear regression were used to assess the correlations between PE and the outcomes.Significant increases were observed in the frequencies of preterm delivery (OR = 2.75, P < 0.001), iatrogenic preterm birth (OR = 3.52, P < 0.001), and IUGR (OR = 2.94, P = 0.001) in the PE group, and the PE group had more than a 2-fold risk of adverse neonatal outcomes. Preeclamptic twin neonates had lower birth weights (β = −147.34, P = 0.005; β = −169.47, P = 0.001). The comparison on the discordance of intertwin weight was not significantly different.Twin pregnancies with PE are associated with worse perinatal outcomes. The adverse outcomes of preeclamptic twin pregnancies may be associated with lower birth weights rather than the discordance of the intertwin weight, which requires further confirmation. The results may provide helpful references for better clinical assessments, evaluations of prognosis, and a deeper understanding of preeclamptic twin pregnancies.

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“…Meanwhile, risk factors associated with PE or IUGR in singleton pregnancy had inability to predict PE or IUGR in twin pregnancy (aside from obesity and egg donation for PE). [ 4 23 24 ] …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of fetal and neonatal outcomes in twin pregnancy with preeclampsia in a retrospective case–control study

Tan

Wang²,

Li³

et al. 2016

Medicine

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“…Kehamilan kembar berada pada peningkatan risiko hampir semua komplikasi kehamilan bila dibandingkan dengan kehamilan tunggal (Fox et al, 2014).…”

Section: Hubungan Kehamilan Kembar Dengan Kejadian Preeklampsiaunclassified

Relationship Between Obesity, Twin-Pregnancy and Previous History of Preeclampsia With Preeclampsia

Parantika

Hardianto²,

Miftahussurur³

et al. 2021

IMHSJ

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Background: Preeclampsia can threaten the health of the mother and fetus during pregnancy and childbirth, besides that it also increases the risk of long-term complications and has the potential to cause death. The incidence of preeclampsia at the RSUD Engku Haji Daud Tanjung Uban showed an increase in the last three years, namely the occurrence from 2017 as many as 23 cases to 56 cases in 2019. The condition of preeclampsia can worsen quickly and without warning, for that, it must be detected and managed appropriately. This study aimed to identify the association of obesity, multiple pregnancies, and previous history of preeclampsia with the incidence of preeclampsia in maternity women. Methods: This study uses a case-control study design. Performed on women giving birth in the period January – December 2019, consisting of 56 cases and 112 controls. Maternal women with preeclampsia were cases and women who were not diagnosed with preeclampsia were controls. The data was obtained from the respondents' medical records, then analyzed using the Chi-Square test or Fisher's Exact test with a value of = 0,05. Results: Obesity was associated with an increased risk of preeclampsia (OR= 4,746, 95% CI 2,381-9,460; P=0,000). Multiple pregnancies were associated with a significantly increased risk of preeclampsia (OR=15,857, 95% CI 1,899-132,384; P=0,002). Likewise, a previous history of preeclampsia was associated with a markedly increased risk of preeclampsia (OR=99,000, 95% CI 22,057-444,343; P=0,000). Conclusion: Based on these data, it was found that obesity, multiple pregnancies, and previous history of preeclampsia were significant risk factors for the occurrence of preeclampsia. It is important to identify risk factors for preeclampsia early, so that appropriate management can be carried out, to prevent complications.

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“…In a study by Levron et al ( 317 ), adjustment for maternal age, gravidity, parity, and chronic hypertension revealed that oocyte donation was independently associated with a higher rate of hypertensive diseases of pregnancy ( P < 0.01). In a twins study, Fox et al ( 318 ) found, on adjusted analysis, that the egg donation independently associated with PE (aOR 2.409, CI 1.051–5.524). The meta-anaysis of Thomopoulos et al ( 319 ) gave a risk ratio for egg donation of 3.60 (CI 2.56–5.05) over controls, a value similar to that of Blázquez et al ( 320 ).…”

Section: Evidence From Epidemiology—semen Can Be Protective Against Pmentioning

confidence: 99%

Immunological Tolerance, Pregnancy, and Preeclampsia: The Roles of Semen Microbes and the Father†

Kenny

Kell

2018

Front. Med.

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Although it is widely considered, in many cases, to involve two separable stages (poor placentation followed by oxidative stress/inflammation), the precise originating causes of preeclampsia (PE) remain elusive. We have previously brought together some of the considerable evidence that a (dormant) microbial component is commonly a significant part of its etiology. However, apart from recognizing, consistent with this view, that the many inflammatory markers of PE are also increased in infection, we had little to say about immunity, whether innate or adaptive. In addition, we focused on the gut, oral and female urinary tract microbiomes as the main sources of the infection. We here marshall further evidence for an infectious component in PE, focusing on the immunological tolerance characteristic of pregnancy, and the well-established fact that increased exposure to the father’s semen assists this immunological tolerance. As well as these benefits, however, semen is not sterile, microbial tolerance mechanisms may exist, and we also review the evidence that semen may be responsible for inoculating the developing conceptus (and maybe the placenta) with microbes, not all of which are benign. It is suggested that when they are not, this may be a significant cause of PE. A variety of epidemiological and other evidence is entirely consistent with this, not least correlations between semen infection, infertility and PE. Our view also leads to a series of other, testable predictions. Overall, we argue for a significant paternal role in the development of PE through microbial infection of the mother via insemination.

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Risk Factors for Preeclampsia in Twin Pregnancies

Abstract: In twin pregnancy, the risk factors independently associated with preeclampsia are egg donation and prepregnancy obesity.

Cited by 17 publications

References 16 publications

Clinical characteristics of fetal and neonatal outcomes in twin pregnancy with preeclampsia in a retrospective case–control study

Clinical characteristics of fetal and neonatal outcomes in twin pregnancy with preeclampsia in a retrospective case–control study

Relationship Between Obesity, Twin-Pregnancy and Previous History of Preeclampsia With Preeclampsia

Immunological Tolerance, Pregnancy, and Preeclampsia: The Roles of Semen Microbes and the Father†

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