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Open AccessArticle

Are Twin Pregnancies Complicated by Weight Discordance or Fetal Growth Restriction at Higher Risk of Preeclampsia?

by 1,2,3, 1,3, 1,3, 4 and 1,2,3,*
1
Twins Trust Centre for Research and Clinical Excellence, St George’s University Hospitals NHS Foundation Trust, London SW17 0RE, UK
2
Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George’s University of London, London SW17 0RE, UK
3
Fetal Medicine Unit, St George’s University Hospitals NHS Foundation Trust, London SW17 0RE, UK
4
Twins Trust, The Manor House, Aldershot GU12 4JU, UK
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(10), 3276; https://doi.org/10.3390/jcm9103276
Received: 27 July 2020 / Revised: 30 September 2020 / Accepted: 8 October 2020 / Published: 13 October 2020
(This article belongs to the Special Issue Improving Perinatal Outcomes in Twin and Multiple Pregnancy)
Studies have reported controversial findings on the association between fetal growth restriction (FGR) or intertwin weight discordance and the risk of hypertensive disorders of pregnancy (HDP) in twin pregnancies. The aim of this study was to investigate the association between twin growth disorders and HDP. Twin pregnancies resulting in two live births at St George’s Hospital between 2000 and 2019 were included. FGR or small-for-gestational-age (SGA) at birth was assessed using singleton and twin reference charts. Intertwin discordance [(large birthweight − small birthweight)/(large birthweight) × 100%)] was calculated. Logistic regression models were performed. SGA (aOR 2.34, 95% CI 1.60–3.44, p < 0.001), intertwin discordance ≥25% (aOR 2.10, 95% CI 1.26–3.49, p = 0.004) and their co-existence (aOR 2.03, 95% CI 1.16–3.54, p = 0.013) were significantly associated with HDP. After adjusting for the known maternal risk factors of HDP and the intertwin discordance, SGA (using the twin charts) was the strongest independent risk factor associated with HDP (aOR 2.12, 95% CI 1.40–3.22, p < 0.001) and preeclampsia (aOR 2.34, 95% CI 1.45–3.76, p < 0.001). This study highlights that the presence of at least one SGA twin is significantly associated with HDP during pregnancy. Therefore, maternal blood pressure should be closely monitored in twin pregnancies complicated by SGA with or without intertwin discordance. View Full-Text
Keywords: preeclampsia; hypertensive disorders of pregnancy; twin pregnancy; fetal growth restriction; small for gestational age; birthweight discordance preeclampsia; hypertensive disorders of pregnancy; twin pregnancy; fetal growth restriction; small for gestational age; birthweight discordance
MDPI and ACS Style

Giorgione, V.; Bhide, A.; Bhate, R.; Reed, K.; Khalil, A. Are Twin Pregnancies Complicated by Weight Discordance or Fetal Growth Restriction at Higher Risk of Preeclampsia? J. Clin. Med. 2020, 9, 3276.

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