Risk factors for preeclampsia in twin pregnancies: a population-based matched case-control study

Lučovnik, Miha; Tul, Nataša; Verdenik, Ivan; Novak, Živa; Blickstein, Isaac

doi:10.1515/jpm-2011-0252

Cited by 39 publications

(25 citation statements)

References 18 publications

(23 reference statements)

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“…37 Increased pre-pregnancy BMI was also a risk factor for PE in twin pregnancies. 38 In addition, above-average weight gain during pregnancy was positively correlated to PE risk. 36 Personal and family history of PE are considered significant risk factors for PE in pregnancy.…”

Section: Risk Factorsmentioning

confidence: 98%

Pregnancy-Induced hypertension

et al. 2015

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pregnancy-induced hypertension (pIh) complicates 6-10% of pregnancies. It is defined as systolic blood pressure (sbp) >140 mmhg and diastolic blood pressure (dbp) >90 mmhg. It is classified as mild (sbp 140-149 and dbp 90-99 mmhg), moderate (sbp 150-159 and dbp 100-109 mmHg) and severe (SBP ≥160 and DBP ≥110 mmHg). PIH refers to one of four conditions: a) pre-existing hypertension, b) gestational hypertension and preeclampsia (pe), c) pre-existing hypertension plus superimposed gestational hypertension with proteinuria and d) unclassifiable hypertension. pIh is a major cause of maternal, fetal and newborn morbidity and mortality. women with pIh are at a greater risk of abruptio placentae, cerebrovascular events, organ failure and disseminated intravascular coagulation. fetuses of these mothers are at greater risk of intrauterine growth retardation, prematurity and intrauterine death. ambulatory blood pressure monitoring over a period of 24 h seems to have a role in predicting deterioration from gestational hypertension to pe. antiplatelet drugs have moderate benefits when used for prevention of pe. treatment of pIh depends on blood pressure levels, gestational age, presence of symptoms and associated risk factors. non-drug management is recommended when sbp ranges between 140-149 mmhg or dbp between 90-99 mmhg. blood pressure thresholds for drug management in pregnancy vary between different health organizations. according to 2013 esh/esc guidelines, antihypertensive treatment is recommended in pregnancy when blood pressure levels are ≥150/95 mmHg. Initiation of antihypertensive treatment at values ≥140/90 mmHg is recommended in women with a) gestational hypertension, with or without proteinuria, b) pre-existing hypertension with the superimposition of gestational hypertension or c) hypertension with asymptomatic organ damage or symptoms at any time during pregnancy. methyldopa is the drug of choice in pregnancy. atenolol and metoprolol appear to be safe and effective in late pregnancy, while labetalol has an efficacy comparable to methyldopa. angiotensin-converting enzyme (ace) inhibitors and angiotensin II antagonists are contraindicated in pregnancy due to their association with increased risk of fetopathy.

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Section: Risk Factorsmentioning

confidence: 98%

Pregnancy-Induced hypertension

et al. 2015

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“…22 411 437 525 616 639 23 417 449 567 686 720 24 448 487 628 767 807 25 524 568 720 869 911 26 641 686 843 998 1042 27 766 815 987 1156 1205 28 868 927 1133 1339 1397 29 935 1010 1272 1536 1610 30 989 1081 1407 1733 1826 31 1071 1177 1552 1926 2033 32 1199 1313 1716 2118 2233 33 1361 1479 1895 2312 2430 34 1536 1656 2081 2505 2625 35 1710 1832 2261 2691 2812 36 1871 1994 2427 2861 2984 37 2009 2133 2572 3012 3137 38 2117 2245 2695 3145 3273 39 2208 2340 2804 3269 3401 40 2307 2443 2923 3403 3539 The analysis of the Slovene data has shown that preeclampsia carries a significantly higher risk for a low birth weight of twins (1500 to 2500 g), regardless of the gestational age, parity or chronicity [10]. By definition, actual growth curves are obtained from ultrasound measurements and we are aware that these differ from curves based on weight at birth.…”

Section: Discussionmentioning

confidence: 99%

Growth curves for twins in Slovenia

Bricelj

Blickstein

Bržan-Šimenc

et al. 2016

The Journal of Maternal-Fetal & Neonatal Medicine

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Abnormalities of fetal growth are more common in twins. We introduce the growth curves for monitoring fetal growth in twin pregnancies in Slovenia. Slovenian National Perinatal Information System for the period between 2002 and 2010 was used to calculate birth weight percentiles for all live born twins for each week from 22nd to 40th week. The calculated percentiles of birth weight for all live-born twins in Slovenia served as the basis for drawing 'growth' curves. The calculated growth curves for twins will help accurately diagnose small or large twin fetuses for their gestational age in the native central European population.

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“…In 2012, Lučovnik et al found that BMI and gestational diabetes are risk factors for preeclampsia in twin pregnancies. 11 However, their study was limited to Slovenian women, they only had a 4.7% incidence of preeclampsia, and they did not perform a logistic regression analysis, limiting their ability to control for confounding variables in their analysis.…”

Section: Discussionmentioning

confidence: 99%

“…For example, in singleton pregnancies, risk factors for preeclampsia include nulliparity, advanced maternal age (AMA), obesity, assisted reproduction, egg donation, gestational diabetes, and black race. [5][6][7] In twin pregnancies specifically, the data regarding risk factors for preeclampsia are limited either by the use of birth certificate data, 8,9 which limit their accuracy, or the fact that certain important risk factors were excluded from the analyses, including maternal body mass index (BMI), 8,9 egg donation, [8][9][10][11] and race, [9][10][11] or the fact that regression analysis was not performed, 11 all of which limit their assessment of confounding risk factors. Additionally, the effect of multifetal pregnancy reduction or spontaneous pregnancy reduction of a higher-order multiple pregnancy to a twin pregnancy on the risk of developing preeclampsia was not studied.…”

mentioning

confidence: 99%

“…Additionally, the effect of multifetal pregnancy reduction or spontaneous pregnancy reduction of a higher-order multiple pregnancy to a twin pregnancy on the risk of developing preeclampsia was not studied. [8][9][10][11] The objective of this study is to estimate the association between various pregnancy risk factors and the development of preeclampsia in twin pregnancies, using data from a large single-center twin pregnancy experience.…”

mentioning

confidence: 99%

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