What is the Actual Relative Risk of Preeclampsia in Twins Compared to Singletons?
BACKGROUND AND PURPOSE:
Twins are delivered earlier compared to singletons and therefore overall rates of preeclampsia between twin and singleton pregnancies may underestimate risk of preterm preeclampsia in twins compared to singletons
Francisco et al. (Ultrasound in Obstetrics and Gynecology, 2017) sought to determine
gestational age at delivery in dichorionic (DC) and monochorionic (MC) twin pregnancies, with and without preeclampsia
relative risk of total and preterm preeclampsia compared with that in singleton pregnancies
Prospectively collected data to study adverse outcomes in twin pregnancies
Patients with twin gestation who had entered care in the first trimester and had aneuploidy screening
Inclusion criteria: phenotypically normal live or stillborn babies at ≥ 24 weeks’ gestation
Singleton controls from 93,297 singleton pregnancies that were examined in the same hospitals
1,789 DC and 430 MC twin pregnancies
Incidence of preeclampsia was 2.3% in singletons, 8.1% in DC twins, 6.0% in MC twins
Compared with singletons, relative risk of total preeclampsia was 3.5 for DC twins and 2.6 for MC twins
Incidence of delivery < 37 weeks’ gestation was 5.5% in singletons, 46.5% in DC twins, 91.4% in MC twins
Incidence of preterm preeclampsia (< 37 weeks’ gestation) was 0.6% in singletons, 5.5% in DC twins, 5.8% in MC twins
Relative risk of preterm preeclampsia was 8.7 for DC twins, 9.1 for MC twins
The hazard ratio for DC and MC twin pregnancies relative to singleton pregnancies were 14 and 23, respectively
DC and MC twins have similar relative risk for preterm preeclampsia
Twins have a significantly higher risk of preterm preeclampsia compared to singletons
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