Department of Obstetrics and Gynecology, CHA Bundang Medical Center, Seongnam-si, Republic of Korea.
J Obstet Gynaecol. 2021 Nov;41(8):1225-1229. doi: 10.1080/01443615.2020.1867969. Epub 2021 Apr 23.
The incidence of twin pregnancy with adenomyosis (AD) is increasing due to advanced maternal age and infertility treatment. We retrospectively analysed the data of 45 dichorionic twin pregnancies complicated with AD in contrast to a control group of dichorionic twin pregnancies without AD ( = 130). Compared with those in the control group, the AD group had a higher overall foetal loss rate (8.9% vs. 0.8%; adjusted = .031; odds ratio (OR), 13.6; 95% confidence interval (CI), 1.27-146.3), higher early preterm delivery rate (20% vs. 6.9%; adjusted = .007; OR, 4.22; 95% CI, 1.47-12.13) and higher rate of hypertensive disorders of pregnancy (26.7% vs. 7.7%; adjusted = .005; OR, 3.94; 95% CI, 1.5-10.2). Patients in the AD group were significantly more likely to require transfusion during or after delivery (17.8% vs. 5.4%; = .026) and have smaller babies (2168 g vs. 2399 g; = .004) compared with those in the control group. This is the first study to report that twin pregnancies with AD may be treated as high-risk for placental dysfunction and may need closer monitoring during pregnancy.Impact Statement The incidence of twin pregnancy with adenomyosis (AD) is increasing due to advanced maternal age and infertility treatment. However, there are very few studies on the effect of AD on pregnancy outcomes. This is the first study to report that twin pregnancies with AD have higher rates of early preterm delivery, hypertensive disorders of pregnancy, and transfusion compared to controls. The results of this study can be used in counselling twin pregnancies with AD. Further research is needed to confirm the current findings.
由于产妇年龄较大和不孕治疗的原因，患有子宫腺肌病（AD）的双胎妊娠的发生率正在增加。我们回顾性分析了 45 例患有 AD 的双绒毛膜双胎妊娠与无 AD 的双绒毛膜双胎妊娠对照组（ = 130）的数据。与对照组相比，AD 组总的胎儿丢失率更高（8.9% vs. 0.8%；调整后 = .031；比值比（OR），13.6；95%置信区间（CI），1.27-146.3），早期早产率更高（20% vs. 6.9%；调整后 = .007；OR，4.22；95% CI，1.47-12.13），妊娠高血压疾病的发生率更高（26.7% vs. 7.7%；调整后 = .005；OR，3.94；95% CI，1.5-10.2）。AD 组患者在分娩期间或之后需要输血的可能性明显更高（17.8% vs. 5.4%； = .026），且婴儿较小（2168 g vs. 2399 g； = .004）。这是第一项报道 AD 双胎妊娠可能被视为胎盘功能障碍高危因素，并需要在妊娠期间进行更密切监测的研究。
研究意义：
由于产妇年龄较大和不孕治疗的原因，患有子宫腺肌病（AD）的双胎妊娠的发生率正在增加。然而，关于 AD 对妊娠结局的影响的研究很少。这是第一项报道 AD 双胎妊娠与对照组相比，早期早产、妊娠高血压疾病和输血的发生率更高的研究。本研究结果可用于咨询 AD 双胎妊娠患者。需要进一步的研究来证实目前的发现。
