Preeclampsia in twin gestations: Association with IVF treatments, parity and maternal age
ABSTRACT To identify maternal factors that increase the risk of preeclampsia in twin gestations and to investigate whether twins conceived by in vitro fertilization (IVF) lead to an increased risk of preeclampsia development.
A retrospective population-based cohort study of twin deliveries was performed. Maternal characteristics and perinatal outcomes were evaluated. Patients' data were obtained from a computerized database and analyzed using SPSS statistical package.
During the study period there were 2628 twin deliveries, and of these 3.1% had severe preeclampsia and 6.16% mild preeclampsia. Patients with severe preeclampsia were more likely to be primiparous, and to have significantly higher frequency of chronic hypertension, gestational diabetes mellitus (GDM), IVF treatments, cesarean delivery, preterm delivery and twin discordancy than in the normotensive patients. Chronic hypertension, pirimiparity, twin discordancy and maternal age were independent risk factors for the development of preeclampsia. In a multivariate regression model including IVF treatment, parity and maternal age as risk factors for preeclampsia, women younger than 35 years that conceived following IVF treatments had an independent risk factor for the development of preeclampsia.
IVF treatments in primiparous patients and age younger than 35 years are independent risk factors for preeclampsia. Twin discordancy is an additional independent risk factor for the occurrence of preeclampsia.
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ABSTRACT: The aim of this study was to identify the incidence, clinical features, and prenatal risk factors for hypertensive disorders, including gestational hypertension (GH) and pre-eclampsia (PE), in twin pregnancies.Journal of Obstetrics and Gynaecology Research 06/2014; 40(6):1584-91. DOI:10.1111/jog.12408 · 0.93 Impact Factor
Revista colombiana de obstetricia y ginecología 09/2008; 59(3):206-215.
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ABSTRACT: Aim: To summarize recent articles on the risk factors of preeclampsia in twin pregnancies from 2002 to 2014. Methods: Recent articles from 2002 to 2014 were searched using PubMed. Results: We found 8 articles analyzing the risk factors of preeclampsia in twin pregnancies and focused on the following three risk factors: i) egg (oocyte) donation, ii) chorionicity (dichorionic (DC) twins vs. monochorionic (MC) twins), iii) assisted reproductive technology (ART) (in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) vs. no-IVF/ICSI). Two articles evaluated the risk of egg (oocyte) donation for developing preeclampsia in twin pregnancies, and both reported that egg (oocyte) donation was a significant risk factor for the occurrence of PE in twin pregnancies. However, the effects of chorionicity and ART on the occurrence of PE in twins are still controversial. Conclusions: We attempted a mini-review on the risk factors of preeclampsia in women with twin pregnancies. Egg (oocyte) donation was a risk factor of preeclampsia in twin pregnancies. Since women with twin pregnancies have an almost three-fold increased risk of PE compared with those with singleton pregnancy, egg (oocyte) donor recipients with multiple pregnancies might face a very high risk of preeclampsia.