Preeclampsia in twin pregnancies: association with selective intrauterine growth restriction

Wu, Dongcai; Huang, Liwu; He, Zhiming; Huang, Xuan; Fang, Qun; Luo, Yang

doi:10.3109/14767058.2015.1070140

Cited by 15 publications

(18 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the human condition, preeclampsia, soluble anti-angiogenic factors have been measured in the maternal circulation 27 . These findings support a theory that interference with fetal angiogenesis may contribute to infant disease and growth restriction 28 29 . We probed into whether UPI increased maternal soluble Flt-1 (sFlt-1) that would bind VEGF and thereby reduce circulating VEGF.…”

Section: Resultssupporting

confidence: 84%

Protective effect of maternal uteroplacental insufficiency on oxygen-induced retinopathy in offspring: removing bias of premature birth

Becker

Wang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

To address the hypothesis that maternal uteroplacental insufficiency (UPI) increases severity of retinopathy of prematurity, we developed a composite rat model of UPI and oxygen-fluctuations and removed premature birth as a confounding factor. Timed-pregnant Sprague-Dawley dams underwent bilateral uterine artery ligation or anesthesia (control) at e19.5. Full-term pups developed in room air (RA) or an oxygen-induced retinopathy (OIR) model. Isolectin-stained retinal flat-mounts were analyzed for percent of areas of avascular/total retina (AVA) and of intravitreal neovascular/total retina (IVNV). Pup weights and serum and mRNA of liver and kidney VEGF, IGF-1, and erythropoietin (EPO) were determined. Multivariable mixed effects linear regressions and Pearson correlations were performed using STATA14. Postnatal growth restriction occurred in pups in UPI/RA, but not in UPI/OIR. Weight gain was similar between UPI/OIR and control/OIR pups. AVA was reduced and a trend toward reduced IVNV was seen in UPI/OIR compared to control/OIR. No difference in birth weights of UPI/OIR vs. control/OIR pups occurred. Serum and renal IGF-1 and EPO were significantly increased in UPI/OIR compared to control/OIR pups. In the absence of prematurity, UPI increased angiogenic factors in association with reduced OIR severity, suggesting that ischemia from UPI could yield protective angiogenic effects by offspring.

show abstract

Section: Resultssupporting

confidence: 84%

Protective effect of maternal uteroplacental insufficiency on oxygen-induced retinopathy in offspring: removing bias of premature birth

Becker

Wang

et al. 2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…The association between fetal growth disorders and the development of hypertension in twin pregnancies has been investigated, with evidence of conflicting results [ 8 , 9 , 10 , 11 , 12 , 13 ]. In small retrospective studies, the association between SGA and preeclampsia was not detected.…”

Section: Discussionmentioning

confidence: 99%

“…This was primarily because authors used singleton-based birthweight reference charts to define SGA, leading to a very high rate of SGA twins in both normotensive and hypertensive twin pregnancies [ 10 , 11 ]. Conversely, SGA was associated with an increased risk of preeclampsia in studies where a twin-specific birthweight chart was used [ 8 , 12 , 13 ]. In our study, SGA and FGR were associated with HDP using either singleton or twin charts; however, these associations were stronger when twin-specific charts were used.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas the association between fetal growth anomalies and HDP has been well established in singleton pregnancies [ 7 ], several studies investigating this relationship in twin pregnancies have reported conflicting results [ 8 , 9 , 10 , 11 , 12 , 13 ]. Despite previous negative findings [ 10 , 11 ], Proctor et al demonstrated that the association between SGA and HDP in dichorionic twin pregnancies seems to be similar to that observed in singleton pregnancies when twin-specific birthweight references were used [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Are Twin Pregnancies Complicated by Weight Discordance or Fetal Growth Restriction at Higher Risk of Preeclampsia?

Giorgione

Bhide

Bhate

et al. 2020

JCM

View full text Add to dashboard Cite

Studies have reported controversial findings on the association between fetal growth restriction (FGR) or intertwin weight discordance and the risk of hypertensive disorders of pregnancy (HDP) in twin pregnancies. The aim of this study was to investigate the association between twin growth disorders and HDP. Twin pregnancies resulting in two live births at St George’s Hospital between 2000 and 2019 were included. FGR or small-for-gestational-age (SGA) at birth was assessed using singleton and twin reference charts. Intertwin discordance [(large birthweight − small birthweight)/(large birthweight) × 100%)] was calculated. Logistic regression models were performed. SGA (aOR 2.34, 95% CI 1.60–3.44, p < 0.001), intertwin discordance ≥25% (aOR 2.10, 95% CI 1.26–3.49, p = 0.004) and their co-existence (aOR 2.03, 95% CI 1.16–3.54, p = 0.013) were significantly associated with HDP. After adjusting for the known maternal risk factors of HDP and the intertwin discordance, SGA (using the twin charts) was the strongest independent risk factor associated with HDP (aOR 2.12, 95% CI 1.40–3.22, p < 0.001) and preeclampsia (aOR 2.34, 95% CI 1.45–3.76, p < 0.001). This study highlights that the presence of at least one SGA twin is significantly associated with HDP during pregnancy. Therefore, maternal blood pressure should be closely monitored in twin pregnancies complicated by SGA with or without intertwin discordance.

show abstract

“…Interestingly, a retrospective cohort study from Chinese twin pregnancies revealed that PE occurred more frequently in selective IUGR (sIUGR) pregnancies than in normal growth twin pregnancies, and sIUGR was associated with increased odds of developing severe PE in twin pregnancies [25] . These 2 studies and ours were coming from different perspectives to look into the correlations between PE and IUGR in twin pregnancies.…”

Section: Discussionmentioning

confidence: 79%

Clinical characteristics of fetal and neonatal outcomes in twin pregnancy with preeclampsia in a retrospective case–control study

Tan

Wang²,

Li³

et al. 2016

Medicine

View full text Add to dashboard Cite

The aim of our study was to compare the clinical characteristics of fetal and neonatal outcomes in twin pregnancies between women with preeclampsia (PE) and those with normotension in a Chinese population.There were 143 preeclamptic women and 367 normotensive women with twin pregnancies included in this retrospective case–control study. The baseline characteristics and perinatal outcomes were collected and compared between the groups. Multiple logistic regression and linear regression were used to assess the correlations between PE and the outcomes.Significant increases were observed in the frequencies of preterm delivery (OR = 2.75, P < 0.001), iatrogenic preterm birth (OR = 3.52, P < 0.001), and IUGR (OR = 2.94, P = 0.001) in the PE group, and the PE group had more than a 2-fold risk of adverse neonatal outcomes. Preeclamptic twin neonates had lower birth weights (β = −147.34, P = 0.005; β = −169.47, P = 0.001). The comparison on the discordance of intertwin weight was not significantly different.Twin pregnancies with PE are associated with worse perinatal outcomes. The adverse outcomes of preeclamptic twin pregnancies may be associated with lower birth weights rather than the discordance of the intertwin weight, which requires further confirmation. The results may provide helpful references for better clinical assessments, evaluations of prognosis, and a deeper understanding of preeclamptic twin pregnancies.

show abstract

Preeclampsia in twin pregnancies: association with selective intrauterine growth restriction

Abstract: sIUGR is associated with increased odds of developing severe PE in twin pregnancies, leading to poorer perinatal outcomes.

Cited by 15 publications

References 23 publications

Protective effect of maternal uteroplacental insufficiency on oxygen-induced retinopathy in offspring: removing bias of premature birth

Protective effect of maternal uteroplacental insufficiency on oxygen-induced retinopathy in offspring: removing bias of premature birth

Are Twin Pregnancies Complicated by Weight Discordance or Fetal Growth Restriction at Higher Risk of Preeclampsia?

Clinical characteristics of fetal and neonatal outcomes in twin pregnancy with preeclampsia in a retrospective case–control study

Contact Info

Product

Resources

About