Wu Xiaoqing, Gu Huifeng, Wang Junlin
Intensive Care Unit, Huzhou Maternity & Child Health Care Hospital, Huzhou, China.
Nursing Department, Huzhou Maternity & Child Health Care Hospital, Huzhou, China.
Front Pediatr. 2023 Aug 21;11:1210569. doi: 10.3389/fped.2023.1210569. eCollection 2023.
The impact of hypertensive disorders of pregnancy (HDP) on outcomes of twin gestations is not clear. We aimed to collate data via this meta-analysis to examine how HDP alters maternal and neonatal outcomes of twin gestations.
Studies comparing pregnancy outcomes of twin gestations based on HDP and published on the databases of PubMed, CENTRAL, Scopus, Web of Science, and Embase between 1 January 2000 to 20 March 2023 were eligible for inclusion.
Twelve studies were included. A cumulative of 355,129 twin gestations were analyzed in the current meta-analysis. The pooled analysis found that the presence of HDP increases the risk of preterm birth (OR: 1.86 95% CI: 1.36, 2.55 = 99%) and cesarean section in twin gestations (OR: 1.36 95% CI: 1.20, 1.54 = 89%). Meta-analysis showed a significantly increased risk of low birth weight (OR: 1.30 95% CI: 1.10, 1.55 = 97%), small for gestational age (OR: 1.30 95% CI: 1.09, 1.55 = 96%) and neonatal intensive care unit admissions (OR: 1.77 95% CI: 1.43, 2.20 = 76%) with HDP in twin gestations. There was no difference in the incidence of 5-min Apgar scores <7 (OR: 1.07 95% CI: 0.87, 1.38 = 79%) but a lower risk of neonatal death (OR: 0.39 95% CI: 0.25, 0.61 = 62%) with HDP.
HDP increases the risk of preterm birth, cesarean sections, low birth weight, SGA, and NICU admission in twin gestations. Contrastingly, the risk of neonatal death is reduced with HDP. Further studies are needed to corroborate the current results.
PROSPERO (CRD42023407725).
妊娠期高血压疾病（HDP）对双胎妊娠结局的影响尚不清楚。我们旨在通过这项荟萃分析整理数据，以研究HDP如何改变双胎妊娠的母婴结局。
比较基于HDP的双胎妊娠妊娠结局且于2000年1月1日至2023年3月20日在PubMed、CENTRAL、Scopus、Web of Science和Embase数据库上发表的研究符合纳入标准。
纳入了12项研究。在当前的荟萃分析中，共分析了355,129例双胎妊娠。汇总分析发现，HDP的存在增加了双胎妊娠早产的风险（比值比：1.86，95%置信区间：1.36，2.55 = 99%）和剖宫产的风险（比值比：1.36，95%置信区间：1.20，1.54 = 89%）。荟萃分析显示，HDP使双胎妊娠低出生体重的风险显著增加（比值比：1.30，95%置信区间：1.10，1.55 = 97%）、小于胎龄儿的风险增加（比值比：1.30，95%置信区间：1.09，1.55 = 96%）以及新生儿重症监护病房收治率增加（比值比：1.77，95%置信区间：1.43，2.20 = 76%）。5分钟阿氏评分<7的发生率没有差异（比值比：1.07，95%置信区间：0.87，1.38 = 79%），但HDP使新生儿死亡风险降低（比值比：0.39, 95%置信区间：0.25, 0.61 = 62%）。
HDP增加了双胎妊娠早产、剖宫产、低出生体重、小于胎龄儿和新生儿重症监护病房收治的风险。相反，HDP降低了新生儿死亡风险。需要进一步研究来证实当前结果。
PROSPERO（CRD42023407725）
