Liu Ting, Gao Rui, Liu Yong, Zhao Ke, Su Xiaolin, Wong Hin Ching, Li Luyao, Xie Binbin, Huang Yuanyan, Qiu Chuhui, He Jiang, Liu Chaoqun
Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China.
Shenzhen Birth Cohort Study Center, Nanshan Maternity and Child Healthcare Hospital of Shenzhen, Shenzhen, China.
Front Pediatr. 2022 Sep 2;10:839882. doi: 10.3389/fped.2022.839882. eCollection 2022.
Hypertensive disorders of pregnancy (HDP) are associated with an increased risk of adverse neonatal outcomes. Although twin pregnancies had a higher risk of developing HDP, it is not known whether HDP in twins will increase the risk of adverse neonatal outcomes. We aimed to assess whether this association differed in singleton and twin pregnancies in women who conceived with assisted reproductive technology (ART).
We finally included 193,590 live births born ART from the National Vital Statistics System (NVSS) for the years 2015-2019. We used Log-binomial regression to evaluate the associations between HDP and the risk of adverse neonatal outcomes in ART mothers.
Among 193,590 ART-treated mothers, there were 140,870 and 52,720 mothers who had singleton pregnancies and twin pregnancies, respectively. Those ART mothers with twin pregnancies had a higher rate of HDP than singleton pregnancies (20.5% vs. 11.0%). In singleton pregnancies, the risks of preterm birth [adjusted risk ratio (aRR)): 2.80, 95% CI 2.67-2.93], low birth weight (aRR: 2.80, 95% CI 2.67-2.93), small for gestational age (aRR: 1.41, 95% CI 1.34-1.49), 5 min Apgar <7 (aRR: 1.66, 95% CI 1.50-1.83) and cesarean section (aRR: 1.23, 95% CI 1.21-1.25) were significantly higher in HDP mothers than in non-HDP mothers respectively. However, in contrast to singleton pregnancies, these associations were weak or reversed in twin pregnancies, after adjusting for confounding factors.
In ART-treated women, although twin pregnancies had a higher HDP rate, the risk of adverse neonatal outcomes associated with HDP was lower than that of singletons.
妊娠高血压疾病（HDP）与不良新生儿结局风险增加相关。尽管双胎妊娠发生HDP的风险更高，但双胎妊娠中的HDP是否会增加不良新生儿结局的风险尚不清楚。我们旨在评估在通过辅助生殖技术（ART）受孕的女性中，单胎和双胎妊娠的这种关联是否存在差异。
我们最终纳入了2015 - 2019年国家生命统计系统（NVSS）中193,590例通过ART出生的活产儿。我们使用对数二项回归来评估ART母亲中HDP与不良新生儿结局风险之间的关联。
在193,590例接受ART治疗的母亲中，分别有140,870例和52,720例母亲为单胎妊娠和双胎妊娠。那些双胎妊娠的ART母亲的HDP发生率高于单胎妊娠（20.5%对11.0%）。在单胎妊娠中，HDP母亲的早产风险[调整风险比（aRR）：2.80，95%CI 2.67 - 2.93]、低出生体重（aRR：2.80，95%CI 2.67 - 2.93）、小于胎龄（aRR：1.41，95%CI 1.34 - 1.49）、5分钟Apgar评分<7（aRR：1.66，95%CI 1.50 - 1.83）和剖宫产（aRR：1.23，95%CI 1.21 - 1.25）分别显著高于非HDP母亲。然而，与单胎妊娠相反，在调整混杂因素后，这些关联在双胎妊娠中较弱或呈相反方向。
在接受ART治疗的女性中，尽管双胎妊娠的HDP发生率较高，但与HDP相关的不良新生儿结局风险低于单胎妊娠。
