Zhu Jie, An Ping, Zhao Huanqiang, Zhao Ying, Zhou Jizi, Zhou Qiongjie, Li Xiaotian, Xiong Yu
Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China.
Front Cardiovasc Med. 2023 Jan 16;9:1073729. doi: 10.3389/fcvm.2022.1073729. eCollection 2022.
To explore the optimal cutoffs of growth discordance for the risk of preeclampsia in twin pregnancies.
A retrospective cohort study in a university hospital which included twins delivered from February 2013 to September 2020. Restrictive cubic spline (RCS) model was applied to the trend of intertwin birthweight difference (BWD) with the risk of preeclampsia. Logistic regression and subgroup analysis were performed to find the cut-off with statistical significance and clinical meaningfulness.
A total of 2,631 women pregnant with twins were enrolled. RCS showed a nonlinear upward trend of preeclampsia with BWD, and the BWD of 15% was the initial rising point. With the confounders adjusted, only the group with BWD ≥ 25% was found to be significantly associated with an increased risk of preeclampsia (adjusted odds ratio [aOR], 2.44; 95% confidence interval [CI]: 1.74-3.42). Additionally, subgroup analysis showed that both monochorionic (MC) and small for gestational age (SGA) twins were more likely to complicate with preeclampsia.
The growth discordance of 15% during pregnancy may be the preventive point of preeclampsia, and 25% may be the interventional point.
探讨双胎妊娠中生长不一致与子痫前期风险的最佳截断值。
在一所大学医院进行一项回顾性队列研究，纳入2013年2月至2020年9月分娩的双胞胎。将限制性立方样条（RCS）模型应用于双胎出生体重差异（BWD）趋势与子痫前期风险的关系。进行逻辑回归和亚组分析以找到具有统计学意义和临床意义的截断值。
共纳入2631例双胎妊娠女性。RCS显示子痫前期风险随BWD呈非线性上升趋势，BWD为15%是初始上升点。在调整混杂因素后，仅发现BWD≥25%的组与子痫前期风险增加显著相关（调整优势比[aOR]，2.44；95%置信区间[CI]：1.74 - 3.42）。此外，亚组分析表明单绒毛膜（MC）和小于胎龄（SGA）双胎更易并发子痫前期。
孕期生长不一致达15%可能是子痫前期的预防点，25%可能是干预点。
