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Войти в исследования Pregnancy hypertension · 2026
Placental pathology and hypertensive disorder of pregnancy in multiple gestation.
СтатьяНазвание и аннотация: Перевод в очереди
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Suresh Sunitha, Freedman Alexa, Chandrasekaran Sandhya, Lee Jungeun, Basic Ena, Plunkett Beth A, Ernst Linda M
Аннотация
OBJECTIVE: Twin gestations have high prevalence of hypertensive disorders of pregnancy (HDP). The underlying placental pathology associated with HDP in twin pregnancies is not well established.
STUDY DESIGN: This is a retrospective cohort study in a single healthcare system. Patients with diamniotic twin gestation and placental pathology were included. Demographic and clinical information was abstracted.
MAIN OUTCOME MEASURES: All placentas were evaluated for the presence (in one or both placentas) of four pathologic categories. Among those with HDP, placental pathology was compared by delivery timing of <36 weeks and ≥ 36 weeks. Multivariable logistic regression was utilized to assess the independent association of placental histology in HDP vs no HDP and subsequently among those with HDP by early (<36 weeks) vs late (≥36 weeks) delivery.
RESULTS: A total of 456 patients were included, 151 of which had HDP (33%). Pregnancies with HDP had CI in 35.1%, MVM in 36.4%, FVM in 36.4% and AI in 24.5%. There was increased MVM among those with HDP (aOR MVM 1.60 95% CI 1.03, 2.46). Among pregnancies with HDP, MVM was increased at <36 weeks vs ≥ 36 weeks (56.1% vs 24.5%, aOR 4.80 (95% CI 2.23, 10.35) p < 0.011), whereas CI was less common (aOR 0.27, 95% CI 0.12, 0.63, p < 0.01).
CONCLUSION: MVM is more common in HDP, especially in those delivering <33 weeks than at term, and CI is more common in HDP delivering at term. Further work is needed in understanding the pathophysiology of HDP in twin gestation.
STUDY DESIGN: This is a retrospective cohort study in a single healthcare system. Patients with diamniotic twin gestation and placental pathology were included. Demographic and clinical information was abstracted.
MAIN OUTCOME MEASURES: All placentas were evaluated for the presence (in one or both placentas) of four pathologic categories. Among those with HDP, placental pathology was compared by delivery timing of <36 weeks and ≥ 36 weeks. Multivariable logistic regression was utilized to assess the independent association of placental histology in HDP vs no HDP and subsequently among those with HDP by early (<36 weeks) vs late (≥36 weeks) delivery.
RESULTS: A total of 456 patients were included, 151 of which had HDP (33%). Pregnancies with HDP had CI in 35.1%, MVM in 36.4%, FVM in 36.4% and AI in 24.5%. There was increased MVM among those with HDP (aOR MVM 1.60 95% CI 1.03, 2.46). Among pregnancies with HDP, MVM was increased at <36 weeks vs ≥ 36 weeks (56.1% vs 24.5%, aOR 4.80 (95% CI 2.23, 10.35) p < 0.011), whereas CI was less common (aOR 0.27, 95% CI 0.12, 0.63, p < 0.01).
CONCLUSION: MVM is more common in HDP, especially in those delivering <33 weeks than at term, and CI is more common in HDP delivering at term. Further work is needed in understanding the pathophysiology of HDP in twin gestation.