Recurrence Risk of Pregnancy Complications in Twin and Singleton Deliveries.

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY American journal of perinatology Pub Date : 2025-02-01 Epub Date: 2024-07-02 DOI:10.1055/a-2358-9770

Marion Granger, Maria Sevoyan, Nansi S Boghossian

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Abstract

Objective: This study aimed to estimate and compare the recurrence risk of preterm birth (PTB), gestational diabetes mellitus (GDM), gestational hypertension (GH), and preeclampsia and eclampsia (PE and E) in subsequent pregnancy groups (index-subsequent) of singleton-singleton (n = 49,868), twin-singleton (n = 448), and singleton-twin (n = 723) pregnancies.

Study design: Birthing individuals from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Consecutive Pregnancy Study (2002-2010) with ≥ 2 singleton or twin deliveries were examined. Adjusted relative risks (aRR) and 95% confidence intervals (CI) for recurrent PTB, GDM, GH, and PE and E were estimated using Poisson regression models with robust variance estimators.

Results: The aRR of PTB and GDM ranged from 1.4 to 5.1 and 5.2 to 22.7, respectively, with the greatest recurrence relative risk for both conditions in singleton-singleton subsequent pregnancies (PTB: aRR = 5.1 [95% CI: 4.8-5.5], GDM: aRR = 22.7 [95% CI: 20.8-24.8]). The aRR of GH and PE and E ranged from 2.8 to 7.6 and 3.2 to 9.2, respectively, with the greatest recurrence relative risk for both conditions in twin-singleton subsequent pregnancies (GH: aRR = 7.6 [95% CI: 2.8-20.5], PE and E: aRR = 9.2 [95% CI: 2.9-28.6]).

Conclusion: Recurrence relative risk was increased for PTB, GDM, GH, and PE and E in all subsequent pregnancy groups, which varied in magnitude based on the birth number of the index and subsequent pregnancy. This information provides insight into risk management for subsequent pregnancies including multiples.

Key points: · Recurrence risk for all conditions is persistent in all subsequent pregnancy groups.. · The magnitude of risk varies by the presence of multiples in the index or subsequent pregnancy.. · Singleton-singleton pregnancies are at the greatest risk of PTB.. · Singleton-singleton pregnancies are at the greatest risk of GDM.. · Twin-singleton pregnancies are at the greatest risk of hypertensive disorders..

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双胞胎和单胎妊娠并发症的复发风险

目的估计并比较单胎-双胎（n = 49,868）、双胎-单胎（n = 448）和单胎-双胎（n = 723）妊娠组（指数-后续）的早产（PTB）、妊娠糖尿病（GDM）、妊娠高血压（GH）以及子痫前期和子痫（PE & E）的复发风险：研究设计：对美国国家儿童健康中心连续妊娠研究（NICHD Consecutive Pregnancy Study，2002-2010 年）中单胎或双胎分娩次数≥ 2 次的分娩个体进行了研究。使用带有稳健方差估计器的泊松回归模型估计了复发性PTB、GDM、GH和PE & E的调整相对风险系数（aRR）和95%置信区间（CI）：PTB和GDM的复发风险分别为1.4 - 5.1和5.2 - 22.7，单胎双胎妊娠的复发风险最大（PTB：aRR=5.1 (95% CI: 4.8-5.5)；GDM：aRR=22.7 (95% CI: 20.8 - 24.8)）。GH和PE&E的复发风险分别为2.8-7.6和3.2-9.2，其中双胎单卵妊娠的复发风险最大（GH：aRR=7.6（95% CI：2.8-20.5），PE&E：aRR=9.2（95% CI：2.9-28.6））：结论：在所有后续妊娠组中，PTB、GDM、GH 和 PE & E 的复发风险都会增加，其增加的幅度因初次妊娠和后续妊娠的胎次而异。这些信息为包括多胎妊娠在内的后续妊娠的风险管理提供了启示。关键词：复发、早产、糖尿病、高血压、子痫前期和子痫。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.