TY - JOUR
T1 - Cardiovascular mortality risk a decade after twin and singleton pregnancies complicated by hypertensive disorders of pregnancy
AU - van Baar, Petra M.
AU - Welters, Sophie M.
AU - Ravelli, Anita C. J.
AU - de Boer, Marjon A.
AU - de Groot, Christianne J. M.
N1 - Funding Information: We thank PERINED for providing the national registry data (www.perined.nl). Results are based on non-public microdata from Statistics Netherlands. Under certain conditions, these microdata are accessible for statistical and scientific research. For further information: microdata@cbs.nl. None. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Publisher Copyright: © 2022 The Author(s)
PY - 2022/6/1
Y1 - 2022/6/1
N2 - Objectives: To describe the cardiovascular mortality (CVM) risk in women after twin versus singleton pregnancies complicated by hypertensive disorders of pregnancy (HDP). Study design: Retrospective cohort study of nulliparous women with a twin or singleton pregnancy who delivered in the Netherlands between 1995 and 2015. We used data of the Perinatal Registry of the Netherlands and data of the National Death Registry to determine baseline data, the occurrence of HDP and CVM. In the two main analyses we compared twin pregnancies complicated by HDP to 1) singleton pregnancies complicated by HDP and 2) uncomplicated twin pregnancies (i.e. without HDP) of women who delivered within a hospital setting. Main outcome measures: CVM risk using cox-proportional hazard models, adjusted for maternal age (aHR). Results: 1,243,231 nulliparous women were included, of which 30,623 (2.5%) had a twin and 1,212,608 (97.5%) had a singleton pregnancy. A total of 9,853 (32.2%) twin pregnancies were complicated by HDP, versus 249,141 (20.6%) singleton pregnancies (p < 0.0001). Within the HDP twin cohort, 14/73 (19.2%) maternal deaths were due to cardiovascular causes, versus 335/1,788 (18.7%) in the HDP singleton cohort and 10/117 (8.6%) in the uncomplicated twin cohort. The corresponding aHR was 2.85 (95% CI 1.26–6.41; p = 0.01) for the HDP twin versus the uncomplicated twin cohort, and 1.05 (95% CI 0.62–1.80; p = 0.85) for the HDP twin versus the HDP singleton cohort. Conclusions: Women after both twin and singleton pregnancies complicated by HDP are at a similarly increased risk of CVM later in life.
AB - Objectives: To describe the cardiovascular mortality (CVM) risk in women after twin versus singleton pregnancies complicated by hypertensive disorders of pregnancy (HDP). Study design: Retrospective cohort study of nulliparous women with a twin or singleton pregnancy who delivered in the Netherlands between 1995 and 2015. We used data of the Perinatal Registry of the Netherlands and data of the National Death Registry to determine baseline data, the occurrence of HDP and CVM. In the two main analyses we compared twin pregnancies complicated by HDP to 1) singleton pregnancies complicated by HDP and 2) uncomplicated twin pregnancies (i.e. without HDP) of women who delivered within a hospital setting. Main outcome measures: CVM risk using cox-proportional hazard models, adjusted for maternal age (aHR). Results: 1,243,231 nulliparous women were included, of which 30,623 (2.5%) had a twin and 1,212,608 (97.5%) had a singleton pregnancy. A total of 9,853 (32.2%) twin pregnancies were complicated by HDP, versus 249,141 (20.6%) singleton pregnancies (p < 0.0001). Within the HDP twin cohort, 14/73 (19.2%) maternal deaths were due to cardiovascular causes, versus 335/1,788 (18.7%) in the HDP singleton cohort and 10/117 (8.6%) in the uncomplicated twin cohort. The corresponding aHR was 2.85 (95% CI 1.26–6.41; p = 0.01) for the HDP twin versus the uncomplicated twin cohort, and 1.05 (95% CI 0.62–1.80; p = 0.85) for the HDP twin versus the HDP singleton cohort. Conclusions: Women after both twin and singleton pregnancies complicated by HDP are at a similarly increased risk of CVM later in life.
KW - Cardiovascular mortality
KW - Hypertension
KW - Preeclampsia
KW - Twin pregnancies
UR - http://www.scopus.com/inward/record.url?scp=85124209368&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.preghy.2022.01.009
DO - https://doi.org/10.1016/j.preghy.2022.01.009
M3 - Article
C2 - 35149273
SN - 2210-7789
VL - 28
SP - 9
EP - 14
JO - Pregnancy Hypertension
JF - Pregnancy Hypertension
ER -