Erez Offer, Vardi Ilana Shoham, Hallak Mordechai, Hershkovitz Reli, Dukler Doron, Mazor Moshe
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
J Matern Fetal Neonatal Med. 2006 Mar;19(3):141-6. doi: 10.1080/14767050500246045.
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.
确定增加双胎妊娠子痫前期风险的母体因素，并调查体外受精（IVF）受孕的双胎是否会增加子痫前期发生的风险。
对双胎分娩进行了一项基于人群的回顾性队列研究。评估了母体特征和围产期结局。患者数据从计算机化数据库中获取，并使用SPSS统计软件包进行分析。
在研究期间，共有2628例双胎分娩，其中3.1%患有重度子痫前期，6.16%患有轻度子痫前期。与血压正常的患者相比，重度子痫前期患者更可能是初产妇，慢性高血压、妊娠期糖尿病（GDM）、IVF治疗、剖宫产、早产和双胎生长不一致的发生率显著更高。慢性高血压、初产、双胎生长不一致和产妇年龄是子痫前期发生的独立危险因素。在一个将IVF治疗、产次和产妇年龄作为子痫前期危险因素的多变量回归模型中，35岁以下接受IVF治疗后受孕的女性是子痫前期发生的独立危险因素。
初产妇接受IVF治疗且年龄小于35岁是子痫前期的独立危险因素。双胎生长不一致是子痫前期发生的另一个独立危险因素。
