Pediatrics, University of Calgary, Calgary, AB, Canada.
Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.
Pediatr Res. 2022 Sep;92(3):748-753. doi: 10.1038/s41390-022-02044-5. Epub 2022 Apr 5.
Hypertensive disorders of pregnancy (HDP) are associated with dysfunctional placentation and are a major cause of maternal and neonatal morbidity and mortality. Twin pregnancies have a larger placental mass and are a risk factor for HDP. The effect of HDP on neonatal outcomes in twin pregnancies is unknown.
Retrospective cohort study using the Canadian Neonatal Network database from 2010-2018 of twin infants <29 weeks gestation born to mothers with HDP and normotensive pregnancies. Using multivariable models, we determined adjusted odds ratios (AORs) and 95% confidence intervals (CI) for mortality, bronchopulmonary dysplasia, severe neurologic injury, severe retinopathy of prematurity (ROP), necrotizing enterocolitis, and nosocomial infection in twin infants of mothers with HDP compared to twin infants of normotensive mothers.
Of the 2414 eligible twin infants <29 weeks gestational age, 164 (6.8%) were born to mothers with HDP and had higher odds of severe ROP (AOR 2.48, 95% CI 1.34-4.59). Preterm twin infants born to mothers with HDP also had higher odds of mortality (AOR 2.02, 95% CI 1.23-3.32). There was no difference in other outcomes.
Preterm twin infants <29 weeks gestation of HDP mothers have higher odds of severe ROP and mortality.
Hypertensive disorders of pregnancy, associated with placental dysfunction, are a major cause of maternal and neonatal morbidity and mortality. Twin pregnancy, associated with a larger placental mass, is a risk factor for hypertensive disorders of pregnancy. The effect of hypertensive disorders of pregnancy on outcomes of preterm twins is unknown. Preterm twins of mothers with hypertensive disorders of pregnancy are at higher risk of severe retinopathy of prematurity and mortality. Our data can be used to counsel parents and identify infants at higher risk of severe retinopathy of prematurity and mortality.
妊娠高血压疾病（HDP）与胎盘功能障碍有关，是母婴发病率和死亡率的主要原因。双胎妊娠的胎盘质量较大，是 HDP 的危险因素。HDP 对双胎妊娠新生儿结局的影响尚不清楚。
使用加拿大新生儿网络数据库（2010-2018 年），对 29 周以下 HDP 和正常血压孕妇所生的双胎婴儿进行回顾性队列研究。采用多变量模型，确定 HDP 母亲所生双胎婴儿与正常血压母亲所生双胎婴儿的死亡率、支气管肺发育不良、严重神经损伤、严重早产儿视网膜病变（ROP）、坏死性小肠结肠炎和医院感染的调整比值比（AOR）和 95%置信区间（CI）。
在 2414 名符合条件的 29 周以下双胎婴儿中，有 164 名（6.8%）母亲患有 HDP，患有严重 ROP 的几率更高（AOR 2.48，95%CI 1.34-4.59）。HDP 母亲所生的早产儿双胞胎也有更高的死亡率（AOR 2.02，95%CI 1.23-3.32）。其他结果没有差异。
HDP 母亲的早产双胞胎<29 周，患有严重 ROP 和死亡率的几率更高。
妊娠高血压疾病与胎盘功能障碍有关，是母婴发病率和死亡率的主要原因。双胎妊娠与较大的胎盘质量有关，是妊娠高血压疾病的危险因素。妊娠高血压疾病对早产儿双胞胎结局的影响尚不清楚。HDP 母亲的早产儿双胞胎患严重早产儿视网膜病变和死亡率的风险更高。我们的数据可用于为父母提供咨询并识别患有严重早产儿视网膜病变和死亡率风险较高的婴儿。
